一种用于指导晚期鼻咽癌个体化治疗的放射基因组临床决策支持系统。

A radiogenomic clinical decision support system to inform individualized treatment in advanced nasopharyngeal carcinoma.

作者信息

Fang Xue-Liang, Zhong Lian-Zhen, Jiang Wei, Huang Cheng-Long, Lei Yuan, Tang Si-Qi, Li Qing-Jie, Liu Li-Zhi, Tian Li, Li Ying-Qin, Chen Yu-Pei, Lin Li, Guo Rui, Li Wen-Fei, Tian Jie, Liu Na, Dong Di, Ma Jun, Tang Ling-Long

机构信息

Department of Radiation Oncology, Sun Yat-sen University Cancer Center, the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Center for Precision Medicine of Sun Yat-sen University, Guangzhou, China.

Department of Otolaryngology, Peking Union Medical College Hospital, Research Units of New Technologies of Endoscopic Surgery in Skull Base Tumor (2018RU003), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

iScience. 2024 Jun 29;27(8):110431. doi: 10.1016/j.isci.2024.110431. eCollection 2024 Aug 16.

Both concurrent chemoradiotherapy (CCRT) and induction chemotherapy (ICT) followed by CCRT are standard care of advanced nasopharyngeal carcinoma (NPC). However, tailoring personalized treatment is lacking. Herein, we established a radiogenomic clinical decision support system to classify patients into three subgroups according to their predicted disease-free survival (DFS) with CCRT and ICT response. The CCRT-preferred group was suitable for CCRT since they achieved good survival with CCRT, which could not be improved by ICT. The ICT-preferred group was suitable for ICT plus CCRT since they had poor survival with CCRT; additional ICT could afford an improved DFS. The clinical trial-preferred group was suitable for clinical trials since they exhibited poor survival regardless of receiving CCRT or ICT plus CCRT. These findings suggest that our radiogenomic clinical decision support system could identify optimal candidates for CCRT, ICT plus CCRT, and clinical trials, and may thus aid in personalized management of advanced NPC.

同步放化疗（CCRT）以及诱导化疗（ICT）后序贯CCRT均为晚期鼻咽癌（NPC）的标准治疗方案。然而，目前尚缺乏个性化治疗方案。在此，我们建立了一个放射基因组临床决策支持系统，根据患者预测的无病生存期（DFS）以及对CCRT和ICT的反应，将患者分为三个亚组。CCRT优先组适合CCRT，因为他们接受CCRT可获得良好生存，ICT无法进一步改善其生存。ICT优先组适合ICT联合CCRT，因为他们接受CCRT时生存较差；额外的ICT可改善DFS。临床试验优先组适合临床试验，因为无论接受CCRT还是ICT联合CCRT，他们的生存均较差。这些发现表明，我们的放射基因组临床决策支持系统可以识别出适合CCRT、ICT联合CCRT以及临床试验的最佳候选者，从而有助于晚期NPC的个性化管理。