ArticleRadiation oncology (London, England)2025
Beyond the ratio of tumor reduction: residual volume after induction chemotherapy emerges as the optimal biomarker in advanced nasopharyngeal cancer.
Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- MRI-based assessment of tumor aggressiveness in nasopharyngeal carcinoma: risk stratification and survival prediction.European radiology · 2026Article
- Association between tumor volume reduction and treatment outcomes in nasopharyngeal carcinoma treated with PCE-based induction chemotherapy and concurrent chemoradiotherapy.International journal of clinical oncology · 2026Article
- Low-dose nivolumab with neoadjuvant chemotherapy and oral metronomic therapy in borderline resectable oral cavity squamous cell carcinoma: a phase II trial.The Lancet regional health. Southeast Asia · 2026Article
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Abstract
purposeTo investigate and compare the prognostic value of tumor volumetric characteristics during induction chemotherapy (IC) for advanced nasopharyngeal carcinoma (NPC). MATERIALS AND
methodsA retrospective cohort of 250 patients with NPC treated with IC followed by radiotherapy or chemoradiotherapy was analyzed. Tumor volumes were measured using MRI at two time points of before-treatment and after-IC. Cohorts with high and low tumor heterogeneity were identified by analyzing the gross tumor volume (GTV) through the gray-level co-occurrence matrix (GLCM). Incorporating the clinical factors, volumetric characteristics (Vpre−IC, Vpost−IC, ΔVabs, and ΔVrel) were evaluated to identify the prognostic value using univariable and multivariable analyses in various cohorts, respectively. Kaplan-Meier survival analyses with median and optimal cutoff values were conducted. Multivariable analysis was repeated on 1 × 105 resampled cohorts with the Bootstrap method to identify the feature importance. Subgroup analyses were performed based on T-category, IC regimens, post-IC treatment protocols, and tumor changes.
resultsThere is virtually no correlation between Vpost−IC and ΔVrel with ρ = -0.08. Various analyses all suggest Vpost−IC emerged as the most robust biomarker across all endpoints (P < 0.001 ∼ 0.002), followed by ΔVrel and T-category, which were more important than the other features. The predictive value of Vpost−IC surpasses that of ΔVrel especially in the high heterogeneity cohort. Specifically, a Vpost−IC value of 20.6 cm³ could be regarded as a threshold provided optimal risk stratification for progression-free survival (PFS) and overall survival (OS).
conclusionVpost−IC is a critical biomarker for determining clinical outcomes in advanced NPC. Patients with Vpost−IC measurements above 20.6 cm³ are classified as high-risk, indicating a requirement for escalating radiotherapy and/or chemotherapy.
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