The prognostic value of volumetric reduction of the target lesions after induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma.

BACKGROUND: We explored whether the volumetric reduction ratio of target lesion after induction chemotherapy (IC) had any prognostic value in nasopharyngeal carcinoma (NPC). METHODS: From 2013 to 2016, 72 NPC patients treated with PCF (paclitaxel, cisplatin, 5-fluorouracil) IC followed by cisplatin-based concurrent chemoradiotherapy were analyzed. The volumes of target lesions before and after IC and survival conditions were assessed. RESULTS: For all cases, volumetric reduction ratios of the total tumor load ≥ optimal cutoff values were significantly associated with increased 2-year progression-free survival, locoregional failure-free survival, and distant metastasis-free survival (DMFS) rates, and for cervical lymph nodes, the volumetric reduction ratio ≥ optimal cutoff value was significant for DMFS (all P < .05). Accordingly, the optimal cutoff values were 24.56% (AUC = 60.5%), 23.91% (AUC = 57.7%), 29.77% (AUC = 75.8%), and 34.17% (AUC = 62.5%), respectively. CONCLUSION: Volumetric reductions of target lesions after IC are independent survival predictors for NPC, especially for those with N2/N3 disease.