Construction of a nomogram model for identifying elderly candidates of concurrent chemoradiotherapy combined with induction chemotherapy for p16-negative nasopharyngeal carcinoma based on clinical biochemical parameters
10.16066/j.1672-7002.2025.07.006
- VernacularTitle:基于临床生化参数识别p16阴性鼻咽癌同步放化疗联合诱导化疗候选老年人群的列线图模型构建
- Author:
Xiaofeng WU
1
;
Jianhong ZHAO
;
Siwei LI
;
Long WAN
;
Shuibin WANG
Author Information
1. 黄冈市中心医院 耳鼻咽喉头颈外科,湖北 黄冈 438000
- Keywords:
Nasopharyngeal Carcinoma;
Aged;
Induction Chemotherapy;
Nomograms;
Models;
concurrent chemoradiotherapy;
p16 negative
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2025;32(7):432-438
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To establish a nomogram model based on clinical and biochemical parameters in elderly patients with p16-negative nasopharyngeal carcinoma and to identify patients who may benefit from concurrent chemoradiotherapy(CCRT)combined with induction chemotherapy(IC).METHODS A total of 142 nasopharyngeal carcinoma patients who received CCRT in Huanggang Central Hospital between June 2021 and May 2024 were retrospectively included for analysis,and the patients were divided into a training set(n=99)and a validation set(n=43)in a ratio of 7:3.Before treatment,all patients underwent a complete physical examination,fiberoptic nasopharyngeal endoscopy,laboratory tests,and plasma Epstein-Barr virus deoxyribonucleic acid(EBV-DNA)level detection.The study endpoint was disease-specific survival(DSS),defined as the time from initial treatment to cancer-related death or the last follow-up date.RESULTS EBV-DNA level,T stage,N stage,albumin(ALB),and lactate dehydrogenase(LDH)were screened by COX and LASSO regression analysis to establish a nomogram model for predicting DSS in nasopharyngeal carcinoma patients.The nomogram model had good discrimination ability[C-index value:0.947(95%CI:0.905-0.990)vs.0.930(95%CI:0.862-0.998)]and accuracy in both the training set and the validation set.The nomogram model was divided into low-risk group,medium-risk group and high-risk group according to risk.There were statistical differences in DSS among the three groups in the training set and validation set(χ2=7.153,9.266,P=0.028,0.010).In the training set and validation set,only the patients in the high-risk group who received IC+CCRT had a longer DSS than those who received CCRT.CONCLUSION The nomogram model of pre-treatment EBV-DNA level,T stage,N stage,ALB,and LDH was used to distinguish high-risk elderly p16-negative nasopharyngeal carcinoma patients,suggesting that this population may be the beneficiary of IC+CCRT in clinical practice.
