Retrospective analysis of patients with nasopharyngeal carcinoma treated during 1976–1985: Survival after local recurrence

The prognostic value of programmed death-ligand 1 (PD-L1) expression in nasopharyngeal carcinoma (NPC) is controversial, with previous studies showing conflicting results. Most NPCs in endemic areas are Epstein-Barr virus (EBV)-positive. Our aim was to evaluate the clinical significance of PD-L1 expression in EBV-positive NPC. We retrospectively analyzed PD-L1 expression on tumor cells (TCs) and immune cells (ICs) by immunohistochemistry in 208 EBV-positive NPC patients who underwent radiotherapy (203 with concurrent chemotherapy). The percentages of TCs and ICs expressing PD-L1 were evaluated respectively. There was a strong correlation between local recurrence and low PD-L1 expression on ICs (p = 0.0012), TCs (p = 0.013) or both (p = 0.000044), whereas all clinical parameters had no influence on local recurrence. Using multivariate analysis, low PD-L1 expression on ICs was an independent adverse prognostic factor (p = 0.0080; HR = 1.88; 95% CI = 1.18–3.00) for disease-free survival. High PD-L1 expression on both ICs and TCs was an independent favorable prognostic factor (p = 0.022; HR = 0.46; 95% CI = 0.24–0.89) for overall survival. We show for the first time that low PD-L1 expression on ICs and TCs strongly correlates with local recurrence in EBV-positive NPC patients after radiation-based therapy. A simple immunohistochemical study for PD-L1 can identify patients prone to local recurrence, and such patients might benefit from more aggressive treatment in future clinical trials.

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A Clinical-Radiomics Nomogram Based on Computed Tomography for Predicting Risk of Local Recurrence After Radiotherapy in Nasopharyngeal Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.637687 ◽

2021 ◽

Vol 11 ◽

Author(s):

Chaohua Zhu ◽

Huixian Huang ◽

Xu Liu ◽

Hao Chen ◽

Hailan Jiang ◽

...

Keyword(s):

Machine Learning ◽

Computed Tomography ◽

Nasopharyngeal Carcinoma ◽

Local Recurrence ◽

Stochastic Gradient Descent ◽

Support Vector ◽

Stable Model ◽

Clinical Factors ◽

Specificity And Sensitivity ◽

Radiomics Signature

Purpose: We aimed to establish a nomogram model based on computed tomography (CT) imaging radiomic signature and clinical factors to predict the risk of local recurrence in nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT).Methods: This was a retrospective study consisting of 156 NPC patients treated with IMRT. Radiomics features were extracted from the gross tumor volume for nasopharynx (GTVnx) in pretreatment CT images for patients with or without local recurrence. Discriminative radiomics features were selected after t-test and the least absolute shrinkage and selection operator (LASSO) analysis. The most stable model was obtained to generate radiomics signature (Rad_Score) by using machine learning models including Logistic Regression, K-Nearest neighbor, Naive Bayes, Decision Tree, Stochastic Gradient Descent, Gradient Booting Tree and Linear Support Vector Classification. A nomogram for local recurrence was established based on Rad_Score and clinical factors. The predictive performance of nomogram was evaluated by discrimination ability and calibration ability. Decision Curve Analysis (DCA) was used to evaluate the clinical benefits of the multi-factor nomogram in predicting local recurrence after IMRT.Results: Local recurrence occurred in 42 patients. A total of 1,452 radiomics features were initially extracted and seven stable features finally selected after LASSO analysis were used for machine learning algorithm modeling to generate Rad_Score. The nomogram showed that the greater Rad_Score was associated with the higher risk of local recurrence. The concordance index, specificity and sensitivity in the training cohort were 0.931 (95%CI:0.8765–0.9856), 91.2 and 82.8%, respectively; whereas, in the validation cohort, they were 0.799 (95%CI: 0.6458–0.9515), 79.4, and 69.2%, respectively.Conclusion: The nomogram based on radiomics signature and clinical factors can predict the risk of local recurrence after IMRT in patients with NPC and provide evidence for early clinical intervention.

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The effect of combined TPF and intensity modulated radiotherapy after TPF induction chemotherapy on locally advanced nasopharyngeal carcinoma: a retrospective analysis

Annals of Palliative Medicine ◽

10.21037/apm-21-2073 ◽

2021 ◽

Vol 10 (9) ◽

pp. 9669-9677

Author(s):

Lu Zheng ◽

Quan Xu ◽

Ziru Yang ◽

Yanping Bei ◽

Jingtao Tong ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Retrospective Analysis ◽

Induction Chemotherapy ◽

Locally Advanced ◽

Intensity Modulated Radiotherapy ◽

Intensity Modulated

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PO-124: Intensity Modulated Radiotherapy (IMRT) in nasopharyngeal carcinoma –a retrospective analysis

Radiotherapy and Oncology ◽

10.1016/s0167-8140(20)30466-7 ◽

2019 ◽

Vol 141 ◽

pp. S52

Author(s):

F. N ◽

C. Kainickal Thommachan ◽

R. Kumar ◽

M. Rafi ◽

P. George ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Retrospective Analysis ◽

Intensity Modulated Radiotherapy ◽

Intensity Modulated

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Radiomic Nomogram: Pretreatment Evaluation of Local Recurrence in Nasopharyngeal Carcinoma based on MR Imaging

Journal of Cancer ◽

10.7150/jca.33345 ◽

2019 ◽

Vol 10 (18) ◽

pp. 4217-4225 ◽

Cited By ~ 5

Author(s):

Lu Zhang ◽

Hongyu Zhou ◽

Dongsheng Gu ◽

Jie Tian ◽

Bin Zhang ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Local Recurrence ◽

Mr Imaging

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RARE-31. TREATMENT OUTCOME OF CHILDREN WITH PLEOMORPHIC XANTHOASTROCYTOMA: RETROSPECTIVE ANALYSIS – A SINGLE INSTITUTION EXPERIENCE

Neuro-Oncology ◽

10.1093/neuonc/noz175.954 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi228-vi228

Author(s):

Ossama Maher ◽

Toba Niazi ◽

Ziad Khatib ◽

John Ragheb

Keyword(s):

Local Recurrence ◽

Retrospective Analysis ◽

Malignant Transformation ◽

Cranial Nerve ◽

Pleomorphic Xanthoastrocytoma ◽

Braf V600e ◽

Biological Behavior ◽

High Local Recurrence Rate ◽

Cranial Nerve Palsies

Abstract BACKGROUND Pleomorphic xanthoastrocytoma (PXA) and anaplastic pleomorphic xanthoastrocytoma (APXA) are two types of rare astrocytomas in pediatrics. There is limited literature reporting their outcomes. METHODS A retrospective analysis of pediatric patients with diagnosis of PXA and APXA treated at Nicklaus Children’s Hospital was conducted using descriptive measures. RESULTS A chart review of patients with brain tumors from 2001 to 2019 revealed that 13 patients (median age 6 years, range 2–17 years) were diagnosed with non-metastatic PXA (n=12) and APXA (n=1). Six patients (46%) were male. Clinical presentation included seizures (n=8), headaches (n=2) cranial nerve palsies (n=2). Diagnostic imaging showed tumor in the temporal lobe (n=5), parietal lobe (n=2), temporoparietal lobe (n=2), frontal lobe (n=1), occipital lobe (n=1), others (n=2). BRAF V600E mutation were identified in three of five analyzed tumors including PXA (n=4) and APXA (n=1). Surgical intervention consisted of gross total resection (n=8) and near/subtotal resection (n=5). Ten patients (76%) required a second surgery (median 2; range 1–4) due to local recurrence. The median time to recurrence was 3 years (range 6 months - 7 years). Three patients (23%) had malignant transformation of PXA, which occurred three to eight years from the initial surgery; one of them also had extensive spinal metastasis. Focal radiation was given to six patients (46%) due to multiple recurrence (n=2), malignant transformation (n=3), APXA (n=1). At a median follow up of 8 years (range 3 to 20 years), eight patients remain alive, three patients had lost to follow up, two patients died from progressive disease. Long-term sequelae varied as follows; seizures (n=5), motor weakness (n=4), cranial nerve palsies (n=2), and learning disability (n=1). CONCLUSION PXA is associated with high local recurrence rate and uncommonly malignant transformation to APXA in pediatrics, which requires close follow-up due to unpredictable biological behavior of these tumors.

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