{
  "abstract": "Background: TNM stage and pretreatment plasma Epstein-Barr virus (EBV) DNA are central to risk assessment in nasopharyngeal carcinoma (NPC), but they do not fully capture host metabolic reserve.\n\nMethods: We retrospectively analyzed 160 patients with non-metastatic NPC treated from 2013 to 2022. The integrated metabolic vulnerability score (IMVS; range, 0-3) assigned 1 point each for stage IVA, triglyceride-to-HDL cholesterol ratio <1.217, and body mass index <23.79 kg/m2. Cox regression and bootstrap internal validation evaluated progression-free survival (PFS), with EBV DNA included as an adjustment variable. A broader 271-patient cohort from the same institution was used only for internal sensitivity analysis.\n\nResults: Thirty-three PFS events occurred in the modeling cohort. Five-year PFS was 100.0%, 91.9%, 72.1%, and 50.0% for IMVS scores 0, 1, 2, and 3, respectively. IMVS remained associated with PFS after adjustment for EBV DNA status (HR, 2.74; bootstrap percentile 95% CI, 1.89-4.75; P<0.001), although EBV DNA status itself was not independently significant in this cohort. The optimism-corrected AUC was 0.715 for stage IVA, THR, and BMI and 0.727 after adding EBV DNA. In the broader same-institution cohort, the association persisted but was attenuated (HR, 1.55; 95% CI, 1.14-2.10; P = 0.005).\n\nConclusion: IMVS is an exploratory, low-cost risk-stratification tool that may complement, rather than replace, TNM stage and plasma EBV DNA. Prospective external validation and recalibration of the data-derived thresholds are required before clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Oncology, The First Affiliated Hospital of Gannan Medical University",
    "The First Clinical Medical College, Gannan Medical University",
    "Department of Oncology, Ma’anshan 17th Metallurgical Hospital",
    "Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Gannan Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jinghua Zhong"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Chunyan Zhou"
    },
    {
      "affs": [
        1
      ],
      "name": "Qiang Yi"
    },
    {
      "affs": [
        1
      ],
      "name": "Kui Zhong"
    },
    {
      "affs": [
        1
      ],
      "name": "Zheng Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Xinting Ouyang"
    },
    {
      "affs": [
        1
      ],
      "name": "Changyong Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiahua Liao"
    },
    {
      "affs": [
        3
      ],
      "name": "Weifeng Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaojun Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a6rv7qsejav4n.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1914286",
  "fulltext_url": null,
  "id": "a6rv7qsejav4n",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1914286/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/a6rv7qsejav4n.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "10.3389/fonc.2026.1914286",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1914286/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "A pretreatment TNM-metabolic vulnerability score with EBV DNA adjustment for risk stratification in non-metastatic nasopharyngeal carcinoma",
  "title_text": "A pretreatment TNM-metabolic vulnerability score with EBV DNA adjustment for risk stratification in non-metastatic nasopharyngeal carcinoma",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T00:21:05Z",
  "url": "https://research.draconitic.com/paper/a6rv7qsejav4n",
  "venue": "Frontiers in Oncology",
  "versions": []
}