通过肿瘤大小变化评估治疗反应是预后预测的重要指标。晚期鼻咽癌（adNPC）生长不规则，因此一维测量可能无法准确地应用于 adNPC 进行结果预测。本研究旨在评估诱导化疗 (IC) 治疗反应的一维和体积测量值，以预测 adNPC 的结果，并将这些值与 RECIST 1.1 指南的值进行比较。治疗前和 IC 后磁共振图像 (MRI)对 124 例 III-IVA 期鼻咽癌患者进行回顾性分析。 IC 前（Dpre 和 Vpre）和 IC 后 MRI（Dpost-IC 和 Vpost-IC）上目标肿瘤（原发肿瘤和两个最大转移淋巴结）的最大一维直径 (D) 和体积的总和以及百分比使用 Cox 计算两次扫描之间 D (Δ D%) 和 V (ΔV%) 的变化，并将其与无病生存期 (DFS)、局部区域无复发生存期 (LRRFS) 和无远处转移生存期 (DMFS) 相关联回归分析。使用 DeLong 检验计算并比较独立测量值和 RECIST 组（RECIST 反应组和无反应组）分别预测疾病复发、局部区域复发和远处转移的曲线下面积 (AUC)。单变量分析显示之间的相关性高 Dpost-IC，但 DFS 和 DMFS 较差 (P < 0.05)，但 LRRFS 则不然 (P = 0.07)；高 Vpost-IC 和低 ΔV%（IC 后体积减少较少），DFS、LRRFS 和 DMFS 较差 (P < 0.05)； Dpre、ΔD% 和 Vpre 与结果之间没有相关性 (P > 0.05)。多变量分析表明 ΔV% 是结果的唯一独立测量值 (P < 0.05)。与 RECIST 组相比，47.9%（中位值）的 ΔV% 显示疾病复发（0.682 对比 0.526，P < 0.01）和局部区域复发（0.782 对比 0.585，P < 0.01）的 AUC 更高，但远处转移则不然（ 0.593 与 0.518，P = 0.26)。在 adNPC 的结果预测中，用于评估 IC 治疗反应的体积测量优于单维测量和 RECIST 指南。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Treatment response evaluated by tumour size change is an important indicator for outcome prediction. Advanced nasopharyngeal carcinoma (adNPC) grows irregularly, and so the unidimensional measurement may not be accurately applied to adNPC for outcome prediction. This study aimed to evaluate values of unidimensional and volumetric measurements for treatment response to induction chemotherapy (IC) for outcome prediction in adNPC and compared the values with that of RECIST 1.1 guideline.Pre-treatment and post-IC magnetic resonance images (MRIs) from 124 patients with stage III-IVA NPC were retrospectively reviewed. Sums of the maximum unidimensional diameters (D) and volumes of the targeted tumours (primary tumour and two largest metastatic lymph nodes) on the pre- (Dpre and Vpre) and post-IC MRIs (Dpost-IC and Vpost-IC) and percentage changes in D (Δ D%) and V (ΔV%) between two scans were calculated and correlated with disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), and distant metastases-free survival (DMFS) using Cox regression analysis. Area under the curves (AUCs) of independent measurements and RECIST groups (RECIST response and non-response groups) for predicting disease recurrence, locoregional recurrence, and distant metastases, respectively, were calculated and compared using the DeLong test.Univariable analysis showed correlations between high Dpost-IC with poor DFS and DMFS (P < 0.05), but not with LRRFS (P = 0.07); high Vpost-IC and low ΔV% (less decrease in volume on post-IC) with poor DFS, LRRFS, and DMFS (P < 0.05); and no correlations between Dpre, ΔD%, and Vpre and the outcomes (P > 0.05). Multivariable analysis showed that ΔV% was the only independent measurement for outcomes (P < 0.05). Compared with RECIST groups, ΔV% of 47.9% (median value) showed a higher AUC for disease recurrence (0.682 versus 0.526, P < 0.01) and for locoregional recurrence (0.782 versus 0.585, P < 0.01), but not for distant metastases (0.593 versus 0.518, P = 0.26).Volumetric measurement to evaluate treatment response to IC outperformed unidimensional measurement and RECIST guideline in outcome prediction in adNPC.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.