Development and validation of a multivariate risk model for distant metastasis of advanced nasopharyngeal carcinoma

摘要: Objective To develop a model based on the clinical variables for evaluating risk of distant metastasis in patients with advanced nasopharyngeal carcinoma (NPC). Methods From September,2007 to June,2015,a total 238 consecutive biopsy-proven NPC stage Ⅲ-Ⅳ(M0) AJCC TNM staging manual were enrolled this study,including 106 male and 34 female median age 45 years (range 18-68 years).In cohort,126 received concurrent chemoradiotherapy,and 24 chemotherapy radiotherapy,and 40 had induction chemotherapy.We used least absolute shrinkage selection operator (LASSO) method select most significant features establishing assessing risks metastasis. Results Among 18 tested,5 significantly associated NPC,including plasma Epstein-Barr virus (EBV) DNA,neutrophil/lymphocytes (NLR),VCA-IgA,concurrent chemotherapy.Based these 5 variables,we established following model:risk score=1.73×EBV DNA+0.54×NLR+0.38×VCA-IgA-0.95×concurrent chemoradiotherapy-2.37×induction chemotherapy+0.51.The cutoff point was-0.62,which classified into high-risk low-risk groups metastasis.This showed good performance predicting (Pl0.01). Conclusions The we herein can be provides assistance decision-making individualized treatment strategy.