title: Nomogram basing pre-treatment parameters predicting early response for locally advanced rectal cancer with neoadjuvant chemotherapy alone: a subgroup efficacy analysis of FOWARC study.
abstract: OBJECTIVE
  To develop an accurate model with pre-treatment parameters to predict tumor regression and down-staging in locally advanced rectal cancer patients, basing the cohort of preoperative chemotherapy alone in FOWARC study.
  
  
  METHODS
  From Jan 2011 to Feb 2015, complete data was available for 137 out of 165 patients who received preoperative chemotherapy alone. All pre-treatment clinical parameters were collected. Tumor regression grade (TRG) 0-1 was defined as good regression, and pathological TNM stage (ypTNM) 0-I after neoadjuvant treatment was defined as good down-staging. Nomogram was established to predict tumor regression and down-staging. The predictive performance of the model was assessed with concordance index and calibration plots.
  
  
  RESULTS
  Of the 137 patients, 10 had TRG 0 (complete regression); 32 patients, TRG 1; and 95 patients, TRG 2 and 3 (poor regression); 56 (40.9%) patients were classified as good down-staging with ypTNM stage 0-I. The predictive nomograms were developed to predict the probability of TRG 0-1 and good down-staging with a C-index of 0.72 (95% CI: 0.604-0.797) and 0.76 (95% CI: 0.681-0.844). Calibration plots showed good statistical performance on internal validation. Predictive factors in the models included tumor length, tumor circumferential extent, age, and ApoA1.
  
  
  CONCLUSIONS
  The model based on available clinical parameters could accurately predict early efficacy with neoadjuvant mFOLFOX6 chemotherapy alone, which might help in patient selection for optimized treatment.
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun-Yat Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun-Yat Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun-Yat Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Huabin
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Lan
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Meijin
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Liang
authors.initials: L
authors.lastname: Kang
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun-Yat Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Jiayu
authors.initials: J
authors.lastname: Ling
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun-Yat Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun-Yat sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, The Sixth Affiliated Hospital of Sun-Yat Sen University, Guangzhou, Guangdong, P.R. China.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Deng
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D049451:Nomograms; D011379:Prognosis; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000473:pathology*; D015996:Survival Rate; D055815:Young Adult
keywords: neoadjuvant chemotherapy; nomogram; predictive; rectal cancer