Buy article

Volume: 0 - Issue: 0

First page: 0 - Last page: 0

L-w. Gu - Y-c. Li - S-y. Xue - B-b. Xiao - D-x. Wen - L-p. Wu - X. Zhang - L-q. Tang - L. Guo - L-t. Liu

DOI: 10.4193/Rhin24.547

BACKGROUND: To develop a prognostic nomogram based on pretreatment 18F-FDG PET-CT radiomics parameters, peripheral blood indicators and clinical characteristics for risk stratification in patients with de novo metastatic nasopharyngeal carcinoma (dmNPC) receiving immunochemotherapy.
METHODOLOGY: The eligible patients were randomly divided into training (n=183) and validation (n=79) cohorts. Least absolute shrinkage and selection operator regression was used for variable selection. Multivariate Cox regression analysis was performed to identify independent prognostic factors for progression-free survival (PFS). The predictive accuracy and discriminative ability of the nomogram were determined with a concordance index (C-index) and calibration curve.
RESULTS: Multivariate Cox analysis suggested that total lesion glycolysis, number of metastases, Epstein–Barr virus DNA, N-stage, lactate dehydrogenase, and total bilirubin were independent predictors of PFS and were used to develop a nomogram that could classify patients into low- and high-risk groups. The C-index of the nomogram for predicting disease progression was 0.75, which was significantly higher than the C-indices of the TNM stage and EBV DNA. The patients were then stratified into low- and high-risk groups based on the calculated scores. The median PFS was significantly higher in the low-risk group than in the high-risk group.
CONCLUSIONS: The proposed nomogram with PET-CT parameters, peripheral blood indicators and clinical characteristics resulted in accurate prognostic prediction for patients with dmNPC receiving chemotherapy plus PD-1 inhibitors and could provide risk stratification for these patients.

Rhinology 0-0: 0-0, 0000