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Yuan SQ, Wu WJ, Qiu MZ, Wang ZX, Yang LP, Jin Y, Yun JP, Gao YH, Li YH, Zhou ZW, Wang F, Xu RH. Development and Validation of a Nomogram to Predict the Benefit of Adjuvant Radiotherapy for Patients with Resected Gastric Cancer. J Cancer 2017; 8:3498-3505. [PMID: 29151934 PMCID: PMC5687164 DOI: 10.7150/jca.19879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/07/2017] [Indexed: 12/18/2022] Open
Abstract
Background: The US guidelines for gastric cancer (GC) recommend adjuvant radiotherapy (ART) combined with 5-fluorouracil as a standard treatment for patients with resected locally advanced GC. However, patient selection criteria for optimizing the use of adjuvant therapies are lacking. In this study, we developed and validated a nomogram to predict the individualized overall survival (OS) benefit of ART among patients with resected ≥stage IB GC. Patients and Methods: The 2002-2006 Surveillance, Epidemiology, and End Results (SEER) data of 5,206 patients with resected GC were used as a training set for the development of a nomogram. The 2007-2008 SEER data of 1,986 patients with resected GC were used as validation data. Results: In the multivariate analysis weighted by inverse propensity score, the efficacy of ART varied by the ratio of positive to examined nodes (Pinteraction <0.01). The magnitude of this difference was included in the nomogram with associated prognosticators to predict the 3- and 5-year OS with and without ART. The nomogram showed significant prognostic superiority to the 8th TNM staging in the training set (Concordance index, 0.68 versus 0.65; P<0.01) and the validation set (Concordance index, 0.68 versus 0.64; P<0.01). Moreover, the calibration was accurate, and the actual efficacy of ART was positively correlated with the nomogram-estimated survival benefit from ART (Pinteraction <0.01 and Pinteraction =0.02 in the training set and the validation set, respectively). Conclusion: The nomogram can aid individualized clinical decision making by estimating the 3- and 5-year OS and potential benefits of ART among patients with resected GC.
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Affiliation(s)
- Shu-Qiang Yuan
- Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Wen-Jing Wu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-sen University Memorial Hospital, Guangzhou, 510120, China
- Department of Breast Oncology, Sun Yat-sen University Memorial Hospital, Guangzhou, 510120, China
| | - Miao-Zhen Qiu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Zi-Xian Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Lu-Ping Yang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Ying Jin
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Jing-Ping Yun
- Department of Pathology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yuan-Hong Gao
- Department of Radiotherapy, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yu-Hong Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Zhi-Wei Zhou
- Department of Gastric Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Feng Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Rui-Hua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
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Palugulla S, Dkhar SA, Kayal S, Narayan SK. Oxaliplatin-induced Peripheral Neuropathy in South Indian Cancer Patients: A Prospective Study in Digestive Tract Cancer Patients. Indian J Med Paediatr Oncol 2017; 38:502-507. [PMID: 29333020 PMCID: PMC5759072 DOI: 10.4103/ijmpo.ijmpo_143_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Purpose: The aim of the current study is to report our prospective experience on the prevalence of oxaliplatin-induced peripheral neuropathy (OXAIPN) in patients with digestive tract cancers treated with oxaliplatin-based combination therapy. Materials and Methods: A total of 219 patients scheduled to be treated with oxaliplatin-based combination therapy were prospectively examined at baseline and follow-up during the therapy between November 2014 and December 2016. The incidence of acute OXAIPN was measured using a descriptive questionnaire (yes/no question) based on sum of number of symptoms present and NCI-CTCAE version 4.03 was applied to clinically grade the severity of chronic OXAIPN. Results: Acute and chronic OXAIPN was found in 108 of 219 (49.3%) and 127 of 219 (58%) patients, respectively. Out of 11 acute OXAIPN symptoms, the vast majority of patients manifested cold-induced pharyngolaryngeal (63.8%) dysesthesias or perioral (61.1%) paresthesias. Development of acute OXAIPN was predictive of subsequent development of chronic OXAIPN (P = 0.0001). All the patients received a median cumulative dose of 780 mg/m2 (range: 130–1040 mg/m2). There was a significant correlation between the patients who received the median cumulative dose and the development of chronic OXAIPN. The incidences of OXAIPN in patients with median cumulative dose of ≤780 mg/m2 was 51/120 (42.5%) and >780 mg/m2 was OXAIPN 76/99 (76.7%) (P = 0.0001). Conclusion: The current study results demonstrate that the vast majority of patients who receive oxaliplatin-based combination chemotherapy will manifest acute OXAIPN that may contribute to the development of chronic peripheral neuropathy on repeated courses of drug administration.
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Affiliation(s)
- Sreenivasulu Palugulla
- Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Steven Aibor Dkhar
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Smita Kayal
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Sunil K Narayan
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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