建立接受免疫化学疗法的新鼻咽癌患者的M1细分：一项多中心，回顾性队列研究
Establishing M1 subdivision for de novo nasopharyngeal carcinoma patients receiving immuno-chemotherapy: A multicenter, retrospective cohort study
影响因子:3.90000
分区:医学2区 / 牙科与口腔外科2区 肿瘤学3区
发表日期:2024 Dec
作者:
Shui-Qing He, Guo-Ying Liu, Ya-Hui Yu, Lin Wang, Guo-Yi Zhang, Ding-Sheng Peng, Wei-Xin Bei, Chun-Lan Chen, Shu-Hui Lv, Ze-Yu Zhao, Ying Huang, Yan-Qun Xiang
摘要
这项研究旨在更好地治疗接受姑息性免疫化学化学疗法（PICT）的从头转移性鼻咽癌（NPC）患者，从而轻松确定了从四个获得一线图片的中心的NOVO转移性NPC患者。我们使用训练队列中的逻辑回归模型开发了预亲疗法总生存率（OS）预测的列图（n = 296）。我们在验证队列中评估了该nom图的性能。总共包括592名患者。中位随访时间为29.83个月。骨转移（HR，2.46; 95％CI，1.01-6.21; P = 0.049）和转移性病变的数量> 3（HR，2.78; 95％CI，1.24-6.24; P = 0.013）是独立的预后指标。生成了一个新的两类M1细分：M1a，由缺乏共存的骨转移和三个以上的转移性病变来定义； M1b的特征是存在共存的骨转移以及三个以上的转移性病变。 M1A与M1B患者的3年OS率为87.1％，比60.3％（P <0.001）。在培训和验证队列中，C-指数为0.652和0.581。在训练队列中，曲线（AUC）下的1年，2和3年面积为0.69、0.68、0.68，验证队列中的0.64、0.6、0.6为0.64、0.6、0.6。 DCA曲线还表明，该列图具有良好的临床实用性。拟议的M1细分为接受PIST的患者提供了良好的OS分离。
Abstract
This study aims to better manage de novo metastatic nasopharyngeal carcinoma (NPC) patients receiving palliative immuno-chemotherapy (PICT), thereby easily determining individual survival outcomes.Patients with de novo metastatic NPC from four centers who received first-line PICT were included. We developed a nomogram for the pretherapy overall survival (OS) prediction using a logistic regression model in the training cohort (n = 296). We assessed the performance of this nomogram in a validation cohort.A total of 592 patients were included. The median follow-up time was 29.83 months. Bone metastasis (HR, 2.46; 95 % CI, 1.01-6.21; p = 0.049) and the number of metastatic lesions > 3 (HR, 2.78; 95 % CI, 1.24-6.24; p = 0.013) were independent prognostic indicators. A new two-category M1 subdivision was generated: M1a, defined by the absence of co-existing bone metastasis and the presence of more than three metastatic lesions; and M1b, characterized by the presence of co-existing bone metastasis and the presence of more than three metastatic lesions. The 3-year OS rates of patients with M1a vs. M1b were 87.1 % vs. 60.3 % (p < 0.001). The C-indexes were 0.652 and 0.581 in the training and validation cohorts. The 1-, 2-, and 3-year areas under the curve (AUC) were 0.69, 0.68, 0.68 in the training cohort and 0.64, 0.6, 0.6 in the validation cohort. DCA curves also indicated that the nomogram has good clinical utility.The proposed M1 subdivision provides good OS segregation for patients receiving PICT.