M1 Stage Subdivisions Based on F-FDG PET-CT Parameters to Identify Locoregional Radiotherapy for Metastatic Nasopharyngeal Carcinoma

Overview

Journal Ther Adv Med Oncol

Specialty Oncology

Date 2022 Aug 19

PMID 35983026

Authors

Hui-Zhi Qiu

Xu Zhang

Sai-Lan Liu

Xue-Song Sun

Yi-Wen Mo

Huan-Xin Lin

Zi-Jian Lu

Jia Guo

Lin-Quan Tang

Hai-Qiang Mai

Li-Ting Liu

Ling Guo

Affiliations

Soon will be listed here.

Abstract

Purpose: To establish a risk classification of de novo metastatic nasopharyngeal carcinoma (mNPC) patients based on F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET-CT) radiomics parameters to identify suitable candidates for locoregional radiotherapy (LRRT).

Methods: In all, 586 de novo mNPC patients who underwent F-FDG PET-CT prior to palliative chemotherapy (PCT) were involved. A Cox regression model was performed to identify prognostic factors for overall survival (OS). Candidate PET-CT parameters were incorporated into the PET-CT parameter score (PPS). Recursive partitioning analysis (RPA) was applied to construct a risk stratification system.

Results: Multivariate Cox regression analyses revealed that total lesion glycolysis of locoregional lesions (LRL-TLG), the number of bone metastases (BMs), metabolic tumor volume of distant soft tissue metastases (DSTM-MTV), pretreatment Epstein-Barr virus DNA (EBV DNA), and liver involvement were independent prognosticators for OS. The number of BMs, LRL-TLG, and DSTM-MTV were incorporated as the PPS. Eligible patients were divided into three stages by the RPA-risk stratification model: M1a (low risk, PPS + no liver involvement), M1b (intermediate risk, PPS + liver involvement, PPS + low EBV DNA), and M1c (high risk, PPS + high EBV DNA). PCT followed by LRRT displayed favorable OS rates compared to PCT alone in M1a patients ( < 0.001). No significant survival difference was observed between PCT plus LRRT and PCT alone in M1b and M1c patients ( > 0.05).

Conclusions: The PPS-based RPA stratification model could identify suitable candidates for LRRT. Patients with stage M1a disease could benefit from LRRT.

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