Prognostic Nomograms For Patients With Nasopharyngeal Carcinoma Based On Primary Tumor Volume And Cervical Nodal Volume

PURPOSE: Our study aimed to establish and validate prognostic nomograms based on gross tumor volume(GTV)and cervical nodal volume(CNV)for nasopharyngeal carcinoma(NPC)patients treated with 2 cycles of concurrent chemoradiotherapy(CCRT).METHODS: From 2012 to 2015,620 eligible patients that had radical treatment at the Cancer Hospital of Shantou University Medical College were recruited for a nomogram study.Variables were determined in a training set of 463 patients from 2012 to 2014 by X-tile analysis,univariate and multivariate Cox proportional hazard analyses,and the least absolute shrinkage and selection operator(LASSO).Another cohort of 157 patients in 2015 was validated with bootstrap resampling.The concordance index(C-index),calibration curves and decision curve analysis(DCA)were applied to assess its discrimination,calibration and clinical application.RESULTS: Independent prognostic variables for overall survival(OS)were age,GTV,CNV,cranial nerve,positive cervical lymph node laterality below the caudal border of cricoid cartilage(LNBC),which were selected for the OS-nomogram.Optimal prognostic variables including GTV,CNV,LNBC,age and Karnofsky performance status(KPS)were incorporated in the nomogram for progression-free survival(PFS).In the training set,the C-index of our nomograms for OS and PFS were 0.755(95% CI,0.704 to 0.807)and 0.698(95% CI,0.652 to 0.744).The calibration curve presented great agreement between actual and nomogrampredicted survival as well as the probability for progression.DCA indicated that our nomograms were of clinical benefit.CONCLUSION: Our nomograms are capable of effective prognostic prediction for patients with NPC.