Hsu Che-Yu, Lin Shih-Min, Ming Tsang Ngan, Juan Yu-Hsiang, Wang Chun-Wei, Wang Wei-Chung, Kuo Sung-Hsin
Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Department of Radiation Oncology, National Taiwan University Cancer Center, National Taiwan University College of Medicine, Taipei, Taiwan.
Clin Transl Radiat Oncol. 2020 Aug 31;25:1-9. doi: 10.1016/j.ctro.2020.08.004. eCollection 2020 Nov.
To develop and validate a magnetic resonance imaging (MRI)-derived radiomic signature (RS) for the prediction of 1-year locoregional failure (LRF) in patients with hypopharyngeal squamous cell carcinoma (HPSCC) who received organ preservation therapy (OPT).
A total of 800 MRI-based features of pretreatment tumors were obtained from 116 patients with HPSCC who received OPT from two independent cohorts. The least absolute shrinkage and selection operator regression model were used to select the features used to develop the RS. Harrell's C-index and corrected C-index were used to evaluate the discriminative ability of RS. The Youden index was used to select the optimal cut-point for risk category.
The RS yielded 1000 times bootstrapping corrected C-index of 0.8036 and 0.78235 in the experimental (n = 82) and validation cohorts (n = 34), respectively. With respect to the subgroup of patients with stage III/IV and cT4 disease, the RS also showed good predictive performance with corrected C-indices of 0.760 and 0.754, respectively. The dichotomized risk category using an RS of 0.0326 as the cut-off value yielded a 1-year LRF predictive accuracy of 79.27%, 79.41%, 76.74%, and 71.15% in the experimental, validation, stage III/IV, and cT4a cohorts, respectively. The low-risk group was associated with a significantly better progression-free laryngectomy-free and overall survival outcome in two independent institutions, stage III/IV, and cT4a cohorts.
The RS-based model provides a novel and convenient approach for the prediction of the 1-year LRF and survival outcome in patients with HPSCC who received OPT.
开发并验证一种基于磁共振成像（MRI）的放射组学特征（RS），用于预测接受器官保留治疗（OPT）的下咽鳞状细胞癌（HPSCC）患者的1年局部区域复发（LRF）情况。
从两个独立队列中接受OPT的116例HPSCC患者的预处理肿瘤中获取了总共800个基于MRI的特征。使用最小绝对收缩和选择算子回归模型选择用于开发RS的特征。采用Harrell's C指数和校正C指数评估RS的判别能力。使用约登指数选择风险分类的最佳切点。
在实验队列（n = 82）和验证队列（n = 34）中，RS的1000次自举校正C指数分别为0.8036和0.78235。对于III/IV期和cT4疾病患者亚组，RS也显示出良好的预测性能，校正C指数分别为0.760和0.754。以0.0326的RS作为截断值进行二分风险分类，在实验、验证、III/IV期和cT4a队列中，1年LRF预测准确率分别为79.27%、79.41%、76.74%和71.15%。在两个独立机构、III/IV期和cT4a队列中，低风险组的无进展、无喉切除生存率和总生存结果明显更好。
基于RS的模型为预测接受OPT的HPSCC患者的1年LRF和生存结果提供了一种新颖且便捷的方法。
