title: A prognostic scoring system for locoregional control in nasopharyngeal carcinoma following conformal radiotherapy.
abstract: OBJECTIVE
  This study established a prognostic scoring system for nasopharyngeal carcinoma (NPC), which estimates the probability of locoregional (LR) control following definitive conformal radiotherapy.
  
  
  METHODS
  Patients with nondisseminated NPC at initial presentation (n = 630) were enrolled in this study. All patients had magnetic resonance imaging of the head and neck and were treated with conformal radiotherapy. Among them, 93% had concurrent chemotherapy, and 76% had postradiation chemotherapy. The extent of the primary tumor, age at diagnosis, primary tumor size, tumor and nodal classification, histology, and serum lactate dehydrogenase (LDH) level before treatment were included in the analysis for building a prognostic scoring system. The end point for this study was LR control.
  
  
  RESULTS
  The prognostic score was defined as the number of adverse prognostic factors present at diagnosis. Four factors had similarly independent prognostic effects (hazard ratio, 2.0-2.6): age >40 years, histologic WHO type I-II, serum LDH level > or =410 U/L, and involvement of two or more sites of the following anatomic structures, i.e., sphenoid floor, clivus marrow, clivus cortex, prevertebral muscles, and petrous bone. The score predicted the 5-year probability of LR control as follows: 0 (15% of the patients), 100%; 1 (42% of the patients), 93%; 2 (29% of the patients), 83%; 3 or higher (13% of the patients), 71%.
  
  
  CONCLUSIONS
  This scoring system is useful in the decision-making for individual patients and the design of clinical trials to improve LR control for advanced-stage NPC.
authors.affiliation: Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
authors.forename: Skye Hongiun
authors.initials: SH
authors.lastname: Cheng
authors.forename: Stella Y
authors.initials: SY
authors.lastname: Tsai
authors.forename: Cheng-Fang
authors.initials: CF
authors.lastname: Horng
authors.forename: K Lawrence
authors.initials: KL
authors.lastname: Yen
authors.forename: James J
authors.initials: JJ
authors.lastname: Jian
authors.forename: Kwan-Yee
authors.initials: KY
authors.lastname: Chan
authors.forename: Ching-Yuan
authors.initials: CY
authors.lastname: Lin
authors.forename: Shian-Der
authors.initials: SD
authors.lastname: Terng
authors.forename: Mei-Hua
authors.initials: MH
authors.lastname: Tsou
authors.forename: Nei-Min
authors.initials: NM
authors.lastname: Chu
authors.forename: Hsin-Hsian
authors.initials: HH
authors.lastname: Chen
authors.forename: Pei-Lin
authors.initials: PL
authors.lastname: Chen
authors.forename: Y L
authors.initials: YL
authors.lastname: Chung
authors.forename: Cheng-I
authors.initials: CI
authors.lastname: Hsieh
authors.forename: Tran-Der
authors.initials: TD
authors.lastname: Tan
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control*; D009367:Neoplasm Staging / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome