A nomogram for predicting survival of patients with locally advanced pancreatic cancer treated with chemoradiotherapy

Seo Hee Choi, Seung Woo Park, Jinsil Seong

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: We developed a nomogram for predicting survival of patients with locally advanced pancreatic cancer (LAPC) after concurrent chemoradiotherapy (CRT) using 18F-flurodeoxyglucose-positron emission tomography (FDG-PET) parameters and CA 19-9 levels. Methods: Based on 426 patients with LAPC who received concurrent CRT between 2004 and 2015, we investigated significant prognostic factors for survival to build a nomogram, including the maximum standardized uptake value (SUVmax) and CA 19-9 levels. Predictive accuracy and discriminative ability were then measured. Results: Median progression-free survival and overall survival (OS) were 9.4 and 15.4 months, respectively, at a median 15-month follow-up. High-dose radiation (EQD2, ≥61 Gy), initial SUVmax <3.5 and CA 19-9 ≤400 U/mL, and surgical resection after CRT were significantly related to prolonged OS by multivariate analysis (p < 0.05). A nomogram model for OS was established and showed good calibration and acceptable discrimination (c-index 0.656). Using the nomogram, 3 different prognosis groups could be identified with a median OS of 25, 15, and 11 months (p < 0.001). Conclusion: A nomogram was developed with high-dose radiation (EQD2, ≥61 Gy), initial SUVmax <3.5, CA 19-9 ≤400 U/mL, and surgical resection after CRT for patients with LAPC. This will help in clinical decision-making and in selecting patients for CRT.

Original languageEnglish
Pages (from-to)340-346
Number of pages7
JournalRadiotherapy and Oncology
Volume129
Issue number2
DOIs
Publication statusPublished - 2018 Nov

Bibliographical note

Funding Information:
The authors would like to thank In Kyung Min and Yun Ho Roh of the Biostatistics Collaboration Unit, Yonsei University College of Medicine, for statistical consultation and data analysis.

Publisher Copyright:
© 2018 Elsevier B.V.

All Science Journal Classification (ASJC) codes

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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