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PLOS ONE

Nomogram for Predicting the Overall Survival of Nasopharyngeal Carcinoma treated with Intensity Modulated Radiation Therapy.

--Manuscript Draft--

Manuscript Number:PONE-D-14-44655

Article Type:Research Article

Full Title:Nomogram for Predicting the Overall Survival of Nasopharyngeal Carcinoma treated

with Intensity Modulated Radiation Therapy.

Short Title:Nomogram for Predicting OS of NPC.

Corresponding Author: C.H. Xie

Wuhan University Zhongnan Hospital

Wuhan, CHINA

Keywords:nasopharyngeal carcinoma, intensity-modulated radiation therapy, nomogram, survival

probability, prognosis

Abstract:Objective

Distant metastases has become the predominant mode of treatment failure in patients

with non-metastatic nasopharyngeal carcinoma (NPC) after intensity-modulated

radiation therapy (IMRT), underlining the need of optimizing systemic chemotherapy.

Patients and Methods

We reviewed the records of 533 patients with non-metastatic NPC who underwent

IMRT with/without concurrent chemotherapy at the department of radiation oncology of

Sun Yat-sen University from 2002 to 2009, which was used to construct nomogram

based on Cox regression. None of these patients received induction or adjuvant

chemotherapy. The performance of monogram was determined by concordance index

(C-index) and calibration curve, and compared with currently used staging systems on

NPC. The results were also validated in an external cohort of 442 patients from the

department of radiation oncology of Wenzhou Medical College at the same period.

Results

Factors with the greatest influence on survival in the model included primary gross

tumor volume, age, tumor stage and nodal stage (2002 Union for International Cancer

Control [UICC] staging system). The C-index of the nomogram for predicting survival

was 0.748 (95% CI, 0.704-0.785), which was statistically higher than that of 2002 UICC

staging system (0.684, P< 0.001). The calibration curve showed good model

calibration with high correlation of nomogram-predicted and observed probability of

overall survival.In the validation cohort, the nomogram also showed good

discrimination and calibration.

Conclusion

The nomogram as proposed in this study accurately predicted the prognos
is for NPC

The nomogram as proposed in this study accurately predicted the prognosis for NPC

patients after IMRT with/without concurrent chemotherapy, which will aid in patient

counseling and systemic therapy advice for patients with a predicted poor prognosis in

endemic regions.

Order of Authors:S.X. Wu

B. Xia

F. Han

R-F Xie

T. Song

L-X Lu

W. Yu

X-W Deng

Q-C He

C. Zhao

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