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Integrating pretreatment 18F-FDG PET-CT parameters, peripheral blood indicators and clinical characteristics in predicting chemotherapy plus immunotherapy outcomes for de novo metastatic nasopharyngeal carcinoma

  • 0Sun Yat-sen University Cancer Center.
Rhinology +

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April 14, 2025

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April 14, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

A new prognostic nomogram accurately predicts progression-free survival in de novo metastatic nasopharyngeal carcinoma (dmNPC) patients receiving immunochemotherapy. This tool combines radiomics, blood markers, and clinical data for effective risk stratification.

Area Of Science

  • Oncology
  • Radiology
  • Medical Imaging

Background

  • Nasopharyngeal carcinoma (NPC) is a significant health concern, particularly in its de novo metastatic stage (dmNPC).
  • Effective risk stratification is crucial for optimizing treatment strategies in dmNPC patients undergoing immunochemotherapy.
  • Current prognostic models may not fully capture the complexity of predicting outcomes in this population.

Purpose Of The Study

  • To develop and validate a prognostic nomogram for predicting progression-free survival (PFS) in patients with dmNPC.
  • To integrate pretreatment 18F-FDG PET-CT radiomics, peripheral blood indicators, and clinical characteristics into a comprehensive risk assessment tool.
  • To enable precise risk stratification for patients with dmNPC receiving immunochemotherapy.

Main Methods

  • A retrospective study involving training (n=183) and validation (n=79) cohorts of dmNPC patients.
  • Least Absolute Shrinkage and Selection Operator (LASSO) regression for feature selection.
  • Multivariate Cox regression analysis to identify independent prognostic factors for PFS.
  • Nomogram construction and evaluation using concordance index (C-index) and calibration curves.

Main Results

  • The nomogram incorporated total lesion glycolysis, number of metastases, Epstein-Barr virus DNA, N-stage, lactate dehydrogenase, and total bilirubin as independent predictors of PFS.
  • The nomogram achieved a C-index of 0.75 for predicting disease progression, outperforming TNM stage and EBV DNA alone.
  • Patients stratified into low- and high-risk groups based on the nomogram showed significantly different median PFS, with the low-risk group having a better prognosis.

Conclusions

  • The developed nomogram provides accurate prognostic prediction for dmNPC patients treated with chemotherapy plus PD-1 inhibitors.
  • The nomogram effectively stratifies patients into distinct risk groups, aiding in personalized treatment planning.
  • This tool integrates advanced imaging (PET-CT radiomics) with accessible clinical and laboratory data for improved outcome prediction.