scholarly journals Radiotherapy dose–volume parameters predict facial lymphedema after concurrent chemoradiation for nasopharyngeal carcinoma

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Donghyun Kim ◽  
Jiho Nam ◽  
Wontaek Kim ◽  
Dahl Park ◽  
Jihyeon Joo ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Concurrent Chemoradiation ◽  
Cancer Center ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Neck Node ◽  
Level I ◽  
Experienced Grade

Abstract Background To investigate risk factors for developing radiation-associated facial lymphedema (FL) in nasopharyngeal carcinoma (NPC) patients after concurrent chemoradiation (CCRT). Methods Clinical data from 87 patients who underwent definitive CCRT for NPC in 2010–2018 was retrospectively evaluated. FL severity was graded using MD Anderson Cancer Center head and neck lymphedema rating scale. Logistic regression analysis was used to examine the factors associated with the presence of moderate/severe FL (grade ≥ 2). Results At a median follow-up of 34 months (range, 18–96), 26/87 (29.9%) patients experienced grade ≥ 2 FL. A majority (84.6%) was experienced grade ≥ 2 FL 3–6 months after CCRT. Mean dose to the level IV, level I-VII neck node and N stage were significantly correlated with grade ≥ 2 FL at univariate analysis. At multivariate analysis, mean dose of level IV neck node (hazard ratio [HR], 1.238; 95% confidence interval [CI] = 1.084–1.414; p = 0.002) and level I-VII neck node (HR, 1.384; 95% CI = 1.121–1.708; p = 0.003) were independent predictors. Receiver Operating Characteristics (ROC) curve analysis showed that cut-off value of mean level IV neck node dose was 58.7 Gy (area under the curve [AUC] = 0.726; 95% CI = 0.614–0.839, p = 0.001) and mean level I-VII neck node dose was 58.6 Gy (AUC = 0.720; 95% CI = 0.614–0.826, p = 0.001) for grade ≥ 2 FL. Conclusions Keeping mean dose to the level IV and level I-VII below 58.7 Gy and 58.6 Gy may reduce the likelihood of moderate/severe FL after CCRT for NPC.

scholarly journals Radiotherapy dose–volume parameters predict facial lymphedema after concurrent chemoradiation for nasopharyngeal carcinoma

2020 ◽  
Author(s):  
Donghyun Kim ◽  
Jiho Nam ◽  
Wontaek Kim ◽  
Dahl Park ◽  
Jihyeon Joo ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Concurrent Chemoradiation ◽  
Cancer Center ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Neck Node ◽  
Level I ◽  
Experienced Grade

Abstract Background To investigate risk factors for developing radiation-associated facial lymphedema (FL) in nasopharyngeal carcinoma (NPC) patients after concurrent chemoradiation (CCRT). Methods Clinical data from 87 patients who underwent definitive CCRT for NPC in 2010–2018 was retrospectively evaluated. FL severity was graded using MD Anderson Cancer Center head and neck lymphedema rating scale. Logistic regression analysis was used to examine the factors associated with the presence of moderate/severe FL (grade ≥ 2). Results At a median follow-up of 34 months (range, 18–96), 26/87 (29.9%) patients experienced grade ≥ 2 FL. A majority (84.6%) was experienced grade ≥ 2 FL 3–6 months after CCRT. Mean dose to the level IV, level I-VII neck node and N stage were significantly correlated with grade ≥ 2 FL at univariate analysis. At multivariate analysis, mean dose of level IV neck node (hazard ratio [HR], 1.238; 95% confidence interval [CI] = 1.084–1.414; p = 0.002) and level I-VII neck node (HR, 1.384; 95% CI = 1.121–1.708; p = 0.003) were independent predictors. Receiver Operating Characteristics (ROC) curve analysis showed that cut-off value of mean level IV neck node dose was 58.7 Gy (area under the curve [AUC] = 0.726; 95% CI = 0.614–0.839, p = 0.001) and mean level I-VII neck node dose was 58.6 Gy (AUC = 0.720; 95% CI = 0.614–0.826, p = 0.001) for grade ≥ 2 FL. Conclusions Keeping mean dose to the level IV and level I-VII below 58.7 Gy and 58.6 Gy may reduce the likelihood of moderate/severe FL after CCRT for NPC.

Association of multidimensional comorbidities with survival in elderly patients with metastatic colorectal cancer treated with chemotherapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21530-e21530
Author(s):  
Ki Hyang Kim ◽  
Jae Jin Lee ◽  
Jongphil Kim ◽  
Fabio Renato Morgado Gomes ◽  
Marina Sehovic ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Proportional Hazards ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Cox Proportional Hazards ◽  
Age At Diagnosis ◽  
Cancer Center ◽  
Ecog Ps ◽  
The Impact

e21530 Background: In geriatric assessments, comorbidity is often assessed with tools such as the Charlson comorbidity index (CCI) and the Cumulative Illness Rating Scale-Geriatrics (CIRS-G). In studies of older patients with colorectal cancer (CRC), comorbidity was mainly measured using the CCI, and inconsistent results about the correlation comorbidity with overall survival (OS) were found. In order to refine our understanding of the impact of comorbidity, we evaluated its correlation with OS using the CIRS-G and heat maps to elicit the subgroups with the highest impact. Methods: We retrospectively reviewed 153 consecutive patients from the Total Cancer Care database, aged ≥65 with stage 4 CRC, who underwent chemotherapy at Moffitt Cancer Center from 2000 to 2015. The association between CIRS-G scores and OS was examined by the Cox proportional hazards regression model. Results: Median age at diagnosis was 71 years. Forty-eight % of patients had an ECOG PS of 0. Median MAX2 score of chemotherapies was 0.119. Median total score of CIRS-G was 8 (1-20) and median severity index was 0.57 (0.07-1.43). The most common comorbidities were vascular, EENT and larynx, and respiratory diseases. Eleven patients had 1 comorbidity and 1 patient had 2 comorbidities at level 4 severity. Median OS of all patients was 25.1 months (95% CI 21.2-27.6). In univariate analysis, the number of CIRS-G level 4 comorbidities was a significant worse prognostic factor for OS (0 vs 1 or 2, HR 2.16, p = 0.017). In multivariate analysis, ECOG PS ≥2, poorly differentiated histology, age at diagnosis and numbers of CIRS-G level 4 comorbidities were significant worse prognostic factors for OS. ECOG PS ≥2 and age at diagnosis were significant worse prognostic factors for unplanned hospitalization. Conclusions: The OS in the elderly metastatic CRC patients was good and similar to the general population with this disease. The number of CIRS-G level 4 comorbidities was associated with worse OS but no specific CIRS-G category was individually associated with OS.

Characterization of cancer pain syndromes (PS) seen at a Comprehensive Cancer Center (CCC) and pain response (PR) to palliative care consultation (PCC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8551-8551
Author(s):  
D. S. Zhukovsky ◽  
J. Palmer ◽  
E. Bruera ◽  
B. Pei ◽  
T. Zhang ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Classification System ◽  
Rating Scale ◽  
Univariate Analysis ◽  
Critical Evaluation ◽  
Numeric Rating Scale ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Prognostic Features ◽  
Palliative Care Consultation

8551 Background: Comparison of cancer PS across settings is challenging due to differences in prognostic features. Data from 1 CCC participating in a multi-site international study of a pain classification system is presented to characterize cancer PS & response to PCC. Methods: The Edmonton Classification System for Cancer Pain was completed by prospective chart review to characterize PS of 100 consecutive hospitalized patients (pts) seen in PCC. Pts were followed until major PR, hospital discharge or death. Major PR was defined as <2 p.r.n. opioid doses/d & pain intensity (PI) <3/10 for 3 consecutive days (d). Results: 85% of pts had pain (n=85), with age 62.9+13.3, 47.1% male & KPS 44.5+23.1. The most common tumor diagnoses were lung (24.7%) & GU (21.2%). Pts were followed for a median of 4 d (0–27). 39% achieved a major PR. Except for steroids (49.4%) & anticonvulsants (29.4%), other adjuvant analgesic use was all <10%. Pain-associated features: *Numeric Rating Scale 0–10, 10=worst suggestivie of alcoholism + Mean morphine equivalent dailydose On univariate analysis, older age (p=.006), lower initial PI (p=.003), lower final PI (p=.001) & lower final MEDD (p=.002) were significantly associated with achieving major PR. On multivariate analysis, lower initial PI (p=.03) & lower final MEDD (p=.02) retained significance for achieving major PR. Conclusions: Only 39%of pts with cancer pain seen in PCC achieve a major PR by discharge or death. Despite aggressive opioid titration, 61% do not achieve a major PR & require better pain management. Potential strategies for achieving improved PR include earlier PCC, identification of more sensitive prognostic variables &critical evaluation of targeted therapies. [Table: see text] No significant financial relationships to disclose.

Association of clinical phenotype and treatment history with survival in adult brainstem glioblastoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13539-e13539
Author(s):  
Jooyeon Nam ◽  
Rebecca A. Harrison ◽  
Shiao-Pei S. Weathers ◽  
Clement Pillainayagam ◽  
John Frederick De Groot ◽  
...  
Keyword(s):  
Functional Status ◽  
Clinical Features ◽  
Tumor Therapy ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
High Rate ◽  
Concurrent Chemoradiation ◽  
Cancer Center ◽  
Gait Abnormality ◽  
The Impact

e13539 Background: Brainstem gliomas are rare, comprising 1-2% of malignant primary brain tumors. Brainstem glioblastoma (bGBM) often poses a therapeutic challenge due to scarcity of evidence guiding treatment, and the high rate of neurologic morbidity. We examined bGBM cases at MD Anderson Cancer Center (MDACC) to characterize the salient clinical features of bGBM, and the impact of therapy on patient survival. Methods: Adult patients with pathologically-confirmed bGBM (N = 34) treated at MDACC between June 2005 and June 2015 were identified from the neurosurgical database. Patients’ clinical, radiographic, and treatment data were extracted from the medical record. Descriptive statistics and Kaplan-Meier analyses were performed. Results: Mean age was 52.5 years (SD = 12.1) and median KPS was 80 (SD = 14.2) at time of diagnosis. Initial surgical intervention included biopsy (82.4%) and resection (17.6%). Most patients were treated with concurrent chemoradiation (N = 18, 52.9%) or sequential radiation followed by chemotherapy (N = 8, 23.5%), and the remainder had no documented post-operative anti-tumor therapy. At the time of this analysis, 82.4% of the cohort had died. Median progression free survival (PFS) was 5.8 months (SD = 6.7) and overall survival (OS) was 8.9 months (SD = 19.6). On univariate analysis, gait abnormality (p = .02), incoordination (p = .002), dysphagia (p = .04), or facial numbness (p = .01) at presentation was associated with shorter OS. KPS of ≥70 at diagnosis was significantly associated with better OS (15.6 vs 3 months, p = .001), and the patients with good functional status were more likely to receive concurrent chemoradiation. Bevacizumab was given as concurrent or adjuvant treatment in 2 and 3 cases, respectively, and did not affect OS (p = .82). Conclusions: This retrospective analysis demonstrates a significant and complex relationship between presenting clinical features, functional status and variable treatments in bGBM and survival outcomes. This evidence contributes to our understanding of bGBM, and highlights areas for further study in this malignant condition.

P3704Silent ischemic brain lesion detected in patients with subclinical paroxysmal atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Kishima ◽  
T Mine ◽  
E Fukuhara ◽  
K Ashida ◽  
M Ishihara
Keyword(s):  
Atrial Fibrillation ◽  
Roc Curve ◽  
Univariate Analysis ◽  
Brain Lesion ◽  
Cardiac Monitoring ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Ischemic Brain ◽  
Increased Risk ◽  
Unexplained Syncope

Abstract Background Long-lasting atrial fibrillation (AF) has been reported to be associated with an increased risk of dementia, independent of clinical stroke. However, the mechanisms or association in patients with subclinical paroxysmal AF (S-PAF) remain unclear. We evaluated whether S-PAF is associated with silent ischemic brain lesion (S-IBL), one of causes of dementia. Methods We studied 46 patients (35 male, 68±15 yrs) without a history of stroke/transient ischemic attack and AF, who implanted insertable cardiac monitoring (ICM) for unexplained syncope (n=33) or embolic stroke of undetermined source (ESUS) (n=13). All patients underwent cerebral magnetic resource imaging (c-MRI), and S-IBL was defined as infarction, lacuna and microbleeds. The lesions in an acute stage were excluded in patients with ESUS. Results AF was detected in 15/46 patients (11 with unexplained syncope and 4 with ESUS) during follow-up of 7.0±6.6 months, and S-IBL was observed in 18/46 patients (9 infarction, 8 lacuna, or 8 microbleeds). Univariate analysis revealed that higher prevalence of AF (61% vs. 14%, p=0.0015), elder age (73±10yrs vs. 65±16yrs, p=0.0445), dyslipidemia (67% vs. 25%, p=0.007), structural heart disease (44% vs. 14%, p=0.0383), and larger left atrium diameter (41±6 mm vs. 37±5 mm, p=0.0267) were related to S-IBL. On multivariate analysis, prevalence of AF was independently associated with S-IBL (p=0.0070, OR 13.4, 95% CI 1.945–155.813). When receiver-operating-characteristics (ROC) curve analysis and prevalence of AF were used to detect S-IBL, the area under the ROC curve was 0.7341 (sensitivity: 61.1%, specificity: 85.7%). Conclusion Subclinical paroxysmal AF is associated with silent ischemic brain lesion and might cause to dementia.

scholarly journals Epidemiology and outcomes of nasopharyngeal carcinoma: Experience from a regional cancer center in Southern India

2017 ◽  
Vol 06 (03) ◽  
pp. 122-124 ◽  
Author(s):  
Rudresha Antapura Haleshappa ◽  
Aditi Harsh Thanky ◽  
Lakshmaiah Kuntegowdanahalli ◽  
Govind Babu Kanakasetty ◽  
Lokanatha Dasappa ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Head And Neck ◽  
Distant Metastasis ◽  
Southern India ◽  
Concurrent Chemoradiation ◽  
Cancer Center ◽  
Weekly Schedule ◽  
Hospital Data ◽  
Male Predominance ◽  
Weekly Cisplatin

Abstract Context: Nasopharyngeal carcinoma (NPC) is a rare head and neck cancer with significant geographical variation. There are limited data on epidemiology and outcomes of NPC reported from Southern India. Settings and Design: Retrospective analysis. Materials and Methods: We analyzed our hospital data between January 2005 and December 2011 with NPC and analyzed their demographic parameters and outcomes with therapy. Results: A total 143 cases of NPC were identified. Median age at presentation was 35 years with male predominance. Majority (84%) of the cases had the WHO Type 3 histology. Nodal metastasis at presentation was seen in 90% of the cases, majority being bilateral. Distant metastasis was seen in 16% of the cases, most commonly at bone, lung, and liver. Concurrent chemoradiation with weekly cisplatin was offered to 84.7% of localized disease while 80% of these also received adjuvant chemotherapy. Complete remission and partial remission were achieved in 66.1% and 15.2% of the cases, respectively. Weekly cisplatin was well tolerated with Grade 3–4 toxicity seen in 22% of cases. At a median follow-up of 20 months, 2-year progression-free survival and overall survival were 67.2% and 79.5%, respectively. Statistical Analysis Used: SPSS software version 20. Conclusion: NPC is a rare head and neck malignancy in Southern India, presenting with advanced stage and more propensity to distant metastasis. It has good outcomes to concurrent chemoradiation with weekly schedule of cisplatin being well-tolerated regime. Further prospective studies to test this schedule and other novel agents in this potentially curable malignancy are warranted.

Psychometric Properties of the Montgomery-Åsberg Depression Rating Scale in Severely Obese Patients

2015 ◽  
Vol 18 ◽  
Author(s):  
Paula Francielle Paiva-Medeiros ◽  
Leorides Severo Duarte-Guerra ◽  
Marco Aurélio Santo ◽  
Francisco Lotufo-Neto ◽  
Yuan-Pang Wang
Keyword(s):  
Depressive Symptoms ◽  
Psychometric Properties ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Total Sample ◽  
Obese Patients ◽  
Class Iii ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Axis I

AbstractObesity is a chronic condition worldwide and has frequent association with major depression. The Montgomery-Åsberg Depression Rating Scale (MADRS) was applied to obese patients in order to detect briefly and systematically depressive symptoms. The objectives were: to estimate the reliability of the MADRS and to investigate the criterion validity of MADRS. The best cut-off point to detect depressive symptoms was determined in comparison with the Structured Clinical Interview for DSM-IV Axis I Diagnosis (SCID-I). The sample was recruited consecutively from the waiting list of a bariatric surgery service of the university clinic. Trained clinical psychologists applied the assessment instruments. The final sample was comprised of 374 class III obese adults (women 79.9 %, mean age 43.3 years [SD 11.6], mean body mass index 47.0 kg/m2 [SD 7.1]). The mean total score of the MADRS was 7.73 (SD 11.33) for the total sample, with a Cronbach’s alpha coefficient of .93. Women presented higher mean score than men (8.08 versus 6.33; p = .23). The best cut-off point was 13/14 in accordance with the Receiver Operating Characteristics (ROC) curve analysis, yielding a sensitivity of .81 and specificity of .85. The overall ability to discriminate depression according to area under the curve was .87. The results showed that the MADRS is a reliable and valid scale to detect depressive symptoms among patients seeking treatment in preoperative period, displaying adequate psychometric properties.

Supplemental folic acid and/or multivitamins in pregnancy is associated with a decreased risk of childhood and adolescent nasopharyngeal carcinoma

2021 ◽  
pp. 1-6
Author(s):  
Yue Yan ◽  
Chuanbo Xie ◽  
Shi Di ◽  
Zhonghao Wang ◽  
Minqing Wu ◽  
...  
Keyword(s):  
Folic Acid ◽  
Family History ◽  
Nasopharyngeal Carcinoma ◽  
Univariate Analysis ◽  
Cancer Center ◽  
Family History Of Cancer ◽  
History Of ◽  
Maternal Consumption ◽  
Exposures During Pregnancy ◽  
History Of Cancer

Abstract The aim of this study was to evaluate the association between prenatal and neonatal period exposures and the risk of childhood and adolescent nasopharyngeal carcinoma (NPC). From January 2009 to January 2016, a total of 46 patients with childhood and adolescent NPC (i.e., less than 18 years of age) who were treated at Sun Yat-sen University Cancer Center were screened as cases, and a total of 45 cancer-free patients who were treated at Sun Yat-sen University Zhongshan Ophthalmic Center were selected as controls. The association between maternal exposures during pregnancy and obstetric variables and the risk of childhood and adolescent NPC was evaluated using logistic regression analysis. Univariate analysis revealed that compared to children and adolescents without a family history of cancer, those with a family history of cancer had a significantly higher risk of childhood and adolescent NPC [odds ratios (OR) = 3.15, 95% confidence interval (CI) = 1.02–9.75, P = 0.046], and the maternal use of folic acid and/or multivitamins during pregnancy was associated with a reduced risk of childhood and adolescent NPC in the offspring (OR = 0.07, 95% CI = 0.02–0.25, P < 0.001). After multivariate analysis, only the maternal use of folic acid and/or multivitamins during pregnancy remained statistically significant. These findings suggest that maternal consumption of folic acid and/or multivitamins during pregnancy is associated with a decreased risk of childhood and adolescent NPC in the offspring.

scholarly journals Neutrophil-to-Lymphocyte Ratio as an Independent Predictor of In-Hospital Mortality in Patients with Acute Intracerebral Hemorrhage

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 622
Author(s):  
Răzvan Alexandru Radu ◽  
Elena Oana Terecoasă ◽  
Cristina Tiu ◽  
Cristina Ghiță ◽  
Alina Ioana Nicula ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Independent Predictor ◽  
Univariate Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Rank Test ◽  
Hospital Death ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Lymphocyte Ratio

Background and Objectives: Neutrophil-to-lymphocyte ratio (NLR), a very low cost, widely available marker of systemic inflammation, has been proposed as a potential predictor of short-term outcome in patients with intracerebral hemorrhage (ICH). Methods: Patients with ICH admitted to the Neurology Department during a two-year period were screened for inclusion. Based on eligibility criteria, 201 patients were included in the present analysis. Clinical, imaging, and laboratory characteristics were collected in a prespecified manner. Logistic regression models and receiver operating characteristics (ROC) curves were used to assess the performance of NLR assessed at admission (admission NLR) and 72 h later (three-day NLR) in predicting in-hospital death. Results: The median age of the study population was 70 years (IQR: 61–79), median admission NIHSS was 16 (IQR: 6–24), and median hematoma volume was 13.7 mL (IQR: 4.6–35.2 mL). Ninety patients (44.8%) died during hospitalization, and for 35 patients (17.4%) death occurred during the first three days. Several common predictors were significantly associated with in-hospital mortality in univariate analysis, including NLR assessed at admission (OR: 1.11; 95% CI: 1.04–1.18; p = 0.002). However, in multivariate analysis admission, NLR was not an independent predictor of in-hospital mortality (OR: 1.04; 95% CI: 0.9–1.1; p = 0.3). The subgroup analysis of 112 patients who survived the first 72 h of hospitalization showed that three-day NLR (OR: 1.2; 95% CI: 1.09–1.4; p < 0.001) and age (OR: 1.05; 95% CI: 1.02–1.08; p = 0.02) were the only independent predictors of in-hospital mortality. ROC curve analysis yielded an optimal cut-off value of three-day NLR for the prediction of in-hospital mortality of ≥6.3 (AUC = 0.819; 95% CI: 0.735–0.885; p < 0.0001) and Kaplan–Meier analysis proved that ICH patients with three-day NLR ≥6.3 had significantly higher odds of in-hospital death (HR: 7.37; 95% CI: 3.62–15; log-rank test; p < 0.0001). Conclusion: NLR assessed 72 h after admission is an independent predictor of in-hospital mortality in ICH patients and could be widely used in clinical practice to identify the patients at high risk of in-hospital death. Further studies to confirm this finding are needed.

scholarly journals Risk Analysis of Severe Thrombocytopenia in Nasopharyngeal Carcinoma During Concurrent Radio-Chemotherapy

2021 ◽  
Author(s):  
Jiasheng Xu ◽  
Quanli Wu ◽  
Luoyong Tang ◽  
Anwen Liu ◽  
Long Huang
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Nasopharyngeal Carcinoma ◽  
Multivariate Regression ◽  
Univariate Analysis ◽  
Multivariate Regression Analysis ◽  
Control Group ◽  
Severe Thrombocytopenia ◽  
Roc Curve Analysis ◽  
Radio Chemotherapy

Abstract Objective:To explore the risk factors and predictive indexes of severe thrombocytopenia during concurrent radio-chemotherapy of nasopharyngeal carcinoma. Methods: Retrospective analysis were performed from the hospitalized patients with nasopharyngeal carcinoma from August 2014 to July 2017 and completed induction chemotherapy and concurrent radio-chemotherapy.Patients were divided into observation and control group according to the lowest platelet count during concurrent chemotherapy. The general information and laboratory examinations were recorded and analyzed by univariate analysis, multivariate regression analysis and ROC curve analysis. Results: Take the factors, including Age, PLT, IBIL, APTT at first visit, WBC, RBC, HGB, PLT, NEUT, APTT,IBIL, FFA, Crea,Urea before radio-chemotherapy, which are significant in univariate analysis into multivariate regression analysis. It turned out that RBC（OR=10.060, 95%CI2.679-37.777, P=0.001）,PLT(OR= 1.020, 95%CI1.006-1.034, P=0.005) and IBIL（OR=0.710,95%CI 0.561-0.898, P= 0.004） are independent predictors of severe TP in NPC. ROC analysis showed that the AUC of RBC, IBIL, PLT, AGE is 0.746(P< 0.001), 0.735（P<0.001）, 0.702(P=0.001), 0.734(P<0.001). New variables called joint predictor was calculated by regression equation (Y=2.309*RBC-0.343*IBIL+0.02*PLT-10.007), the AUC of which is 0.870(P<0.001), best truncation value is＞5.87 mmol/L. Conclusions: Lower RBC, PLT, higher IBIL before concurrent radio-chemotherapy are the independent risk factors causing severe TP during concurrent radio-chemotherapy of NPC. The RBC, PLT, IBIL before concurrent radio-chemotherapy and joint predictor have a good predictive value to evaluate the risk of severe TP during concurrent radio-chemotherapy of NPC.

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