Prediction Of Tumor Response To Neoadjuvant Chemotherapy In Locally Advanced Nasopharyngeal Carcinoma And Its Predictive Model

Purpose:To explore the factors influencing the short-term efficacy of neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma and to establish a predictive model for Nomograms, and Provide the basis for the local advanced nasopharyngeal carcinoma in the neoadjuvant individualized treatment.Methods:Retrospective analysis of 239 cases of cancer hospital in Sichuan province from January 2011 to December 2015, stage Ⅲ-Ⅳb and completed 2 cycles of neoadjuvant chemotherapy (chemotherapy regimen for TPF, TP, GP, PF) in patients with locally advanced nasopharyngeal carcinoma. According to RECIST standard to evaluate the curative effect of tumor in the near future, through the MRI data of patients before and after neoadjuvant chemotherapy. Using Logistic regression model to analyze the clinical data of patients before neoadjuvant chemotherapy, the Nomograms prediction model was constructed by R software based on the results of multivariate analysis.Results:After 2 cycles of neoadjuvant chemotherapy,112 (47%) patients received CR/PR,89 (49.7%) patients with cervical metastatic lymph nodes were obtained by CR/PR. Multivariate Logistic analysis showed that the neutrophil counts, neutrophil/lymphocyte ratio, lactate dehydrogenase level is the primary tumor to the independent factor of CR/PR (p<0.05). Lactate dehydrogenase level, lymphocyte/monocyte proportion, monocyte count, and neoadjuvant regimen were independent factors influencing lymph node CR/PR (p<0.05) Results using R software to build the nomograms of the prediction model of the primary tumor long diameter reduction is greater than 30%, more than 50%are predicted and nomograms of the model showed good resolution in accordance with the multi factor analysis, C-index were 0.660,0.674, in line with the average absolute deviation is 0.02,0.011; Cervical metastatic lymph nodes to reduce the length of more than 30%, greater than 50% to predict, C-index were: 0.708,0.688, the average absolute difference of 0.027,0.022.Conclusions:1.NLR, LDH higher locally advanced nasopharyngeal cancer patients with neoadjuvant chemotherapy after the primary tumor is more likely to get CR/PR. LDH was higher and LMR was lower in the patients with advanced nasopharyngeal carcinoma after neoadjuvant chemotherapy and the lymph nodes were more likely to receive CR/PR.2. The short term efficacy of neoadjuvant chemotherapy using GP regimen may be superior to TP, TPF,PF regimen in patients with locally advanced nasopharyngeal carcinoma in the N2-3 phase.3. This study established a good nomograms prediction model of short-term effect on neoadjuvant chemotherapy for locally advanced nasopharyngeal carcinoma, provide the basis for individualized neoadjuvant therapy.