The following is a summary of “Integrating pretreatment MRI-detected nodal features and Epstein-Barr virus DNA to identify optimal candidates for intensity-modulated radiotherapy alone in patients with stage II nasopharyngeal carcinoma,” published in the November 2023 issue of Oncology by Guo, et al.

For a retrospective study, researchers sought to develop and validate a prognostic nomogram for stage II nasopharyngeal carcinoma (NPC) based on MRI-detected features of retropharyngeal and cervical lymph nodes, as well as Epstein–Barr virus (EBV) DNA to identify patients who are at low risk and for whom intensity-modulated radiotherapy (IMRT) alone is sufficient. 

A total of 894 patients, including 596 training patients and 298 validation patients, were enrolled in the research. These patients were treated with IMRT ± chemotherapy between August 2010 and May 2019. The use of multivariate analysis allowed for the identification of independent risk variables. These risk factors were gamma-glutamyl transferase (γ-GGT), extracapsular spread of cervical and retropharyngeal lymph nodes, and cervical nodal necrosis. 

The clinical, clinical-radiological, and combination models were used to generate three different nomograms denoted by the letters A, B, and C, respectively). Comparatively, nomogram C, which included EBV DNA, exhibited better risk discrimination (C-index 0.769) in comparison to nomograms A (0.619), B (0.762), and TNM stage (0.560). It was shown that there were no significant variations in survival rates between patients who were treated with radiation alone and those who were treated with various regimens, including further chemotherapy, in the low-risk category that was identified by nomogram C. Prognostic risk assessment for stage II non-small cell lung cancer was enhanced by the nomogram that included MRI characteristics and EBV DNA, which helped in the decision-making process about therapy.

Source: sciencedirect.com/science/article/abs/pii/S1368837523002701