Volpe Stefania, Gaeta Aurora, Colombo Francesca, Zaffaroni Mattia, Mastroleo Federico, Vincini Maria Giulia, Pepa Matteo, Isaksson Lars Johannes, Turturici Irene, Marvaso Giulia, Ferrari Annamaria, Cammarata Giulio, Santamaria Riccardo, Franzetti Jessica, Raimondi Sara, Botta Francesca, Ansarin Mohssen, Gandini Sara, Cremonesi Marta, Orecchia Roberto, Alterio Daniela, Jereczek-Fossa Barbara Alicja
Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Via Ripamonti, 435, 20141 Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy.
Cancers (Basel). 2023 Mar 28;15(7):2022. doi: 10.3390/cancers15072022.
To assess whether CT-based radiomics and blood-derived biomarkers could improve the prediction of overall survival (OS) and locoregional progression-free survival (LRPFS) in patients with oropharyngeal cancer (OPC) treated with curative-intent RT.
Consecutive OPC patients with primary tumors treated between 2005 and 2021 were included. Analyzed clinical variables included gender, age, smoking history, staging, subsite, HPV status, and blood parameters (baseline hemoglobin levels, neutrophils, monocytes, and platelets, and derived measurements). Radiomic features were extracted from the gross tumor volumes (GTVs) of the primary tumor using pyradiomics. Outcomes of interest were LRPFS and OS. Following feature selection, a radiomic score (RS) was calculated for each patient. Significant variables, along with age and gender, were included in multivariable analysis, and models were retained if statistically significant. The models' performance was compared by the C-index.
One hundred and five patients, predominately male (71%), were included in the analysis. The median age was 59 (IQR: 52-66) years, and stage IVA was the most represented (70%). HPV status was positive in 63 patients, negative in 7, and missing in 35 patients. The median OS follow-up was 6.3 (IQR: 5.5-7.9) years. A statistically significant association between low Hb levels and poorer LRPFS in the HPV-positive subgroup ( = 0.038) was identified. The calculation of the RS successfully stratified patients according to both OS (log-rank < 0.0001) and LRPFS (log-rank = 0.0002). The C-index of the clinical and radiomic model resulted in 0.82 [CI: 0.80-0.84] for OS and 0.77 [CI: 0.75-0.79] for LRPFS.
Our results show that radiomics could provide clinically significant informative content in this scenario. The best performances were obtained by combining clinical and quantitative imaging variables, thus suggesting the potential of integrative modeling for outcome predictions in this setting of patients.
评估基于CT的放射组学和血液衍生生物标志物能否改善接受根治性放疗的口咽癌（OPC）患者总生存期（OS）和局部区域无进展生存期（LRPFS）的预测。
纳入2005年至2021年间接受原发性肿瘤治疗的连续性OPC患者。分析的临床变量包括性别、年龄、吸烟史、分期、亚部位、人乳头瘤病毒（HPV）状态和血液参数（基线血红蛋白水平、中性粒细胞、单核细胞和血小板以及衍生测量值）。使用pyradiomics从原发性肿瘤的大体肿瘤体积（GTV）中提取放射组学特征。感兴趣的结局为LRPFS和OS。在特征选择后，为每位患者计算放射组学评分（RS）。将显著变量以及年龄和性别纳入多变量分析，若具有统计学意义则保留模型。通过C指数比较模型的性能。
105例患者纳入分析，以男性为主（71%）。中位年龄为59岁（四分位间距：52 - 66岁），IV A期最为常见（70%）。63例患者HPV状态为阳性，7例为阴性，35例缺失。OS的中位随访时间为6.3年（四分位间距：5.5 - 7.9年）。在HPV阳性亚组中，低血红蛋白水平与较差的LRPFS之间存在统计学显著关联（P = 0.038）。RS的计算成功地根据OS（对数秩检验P < 0.0001）和LRPFS（对数秩检验P = 0.0002）对患者进行了分层。临床和放射组学模型的C指数在OS方面为0.82 [置信区间：0.80 - 0.84]，在LRPFS方面为0.77 [置信区间：0.75 - 0.79]。
我们的结果表明，在这种情况下放射组学可以提供具有临床意义的信息内容。通过结合临床和定量影像变量获得了最佳性能，因此表明在这类患者中综合建模对结局预测具有潜力。
