Nasopharyngeal carcinoma: novel MRI tool predicts response to induction chemotherapy

  • Dong D & al.
  • BMC Med
  • 23 Oct 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • The Induction Chemotherapy Outcome Score (ICTOS), based on MRI features, is predictive of failure-free survival (FFS) after concurrent chemoradiotherapy (CCRT)±induction chemotherapy (IC) in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).

Why this matters

  • Better prognostic tools will help improve patient management.

Key results

  • In training cohort patients with high (>0) ICTOS, IC+CCRT was associated with improved FFS vs CCRT alone (3-year FFS, 69.3% vs 45.6%; 5-year FFS, 64.0% vs 36.5%; HR, 0.43; P=.002).
    • These results were confirmed in a validation cohort (3-year FFS, 89.7% vs 61.8%; 5-year FFS, 89.7% vs 52.8%; HR, 0.17; P<.001>
  • In patients with low ICTOS (≤0), IC+CCRT and CCRT alone had similar FFS outcomes (HR, 1.78 [P=.063] in the training cohort; HR, 0.75 [P=.31] in the validation cohort).

Study design

  • 254 patients with LA-NPC were included in the retrospective training cohort.
  • 248 patients with LA-NPC were included in the prospective validation cohort.
  • Funding: Natural Science Foundation of Guangdong; National Key R&D Program of China; National Natural Science Foundation of China; Health & Medical Collaborative Innovation Project of Guangzhou City; Innovation Team Development Plan of the Ministry of Education; Beijing Natural Science Foundation; Youth Innovation Promotion Association.

Limitations

  • Retrospective nature of the training set.