CT Radiomics Nomogram Predicts Pathological Response After Induced Chemotherapy and Overall Survival in Patients with Advanced Laryngeal Cancer: A Single-center Retrospective Study

Overview

Journal Front Oncol

Specialty Oncology

Date 2023 Apr 17

PMID 37064100

Authors

Chunmiao Kang

Pengfeng Sun

Runqin Yang

Changming Zhang

Wenfeng Ning

Hongsheng Liu

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aimed to develop a radiomics nomogram to predict pathological response (PR) after induction chemotherapy (IC) and overall survival (OS) in patients with advanced laryngeal cancer (LC).

Methods: This retrospective study included patients with LC (n = 114) who had undergone contrast computerized tomography (CT); patients were randomly assigned to training (n = 81) and validation cohorts (n = 33). Potential radiomics scores were calculated to establish a model for predicting the PR status using least absolute shrinkage and selection operator (LASSO) regression. Multivariable logistic regression analyses were performed to select significant variables for predicting PR status. Kaplan-Meier analysis was performed to assess the risk stratification ability of PR and radiomics score (rad-score) for predicting OS. A prognostic nomogram was developed by integrating radiomics features and clinicopathological characteristics using multivariate Cox regression. All LC patients were stratified as low- and high-risk by the median CT radiomic score, C-index, calibration curve. Additionally, decision curve analysis (DCA) of the nomogram was performed to test model performance and clinical usefulness.

Results: Overall, PR rates were 45.6% (37/81) and 39.3% (13/33) in the training and validation cohorts, respectively. Eight features were optimally selected to build a rad-score model, which was significantly associated with PR and OS. The median OS in the PR group was significantly shorter than that in the non-PR group in both cohorts. Multivariate Cox analysis revealed that volume [hazard ratio, (HR) = 1.43], N stage (HR = 1.46), and rad-score (HR = 2.65) were independent risk factors associated with OS. The above four variables were applied to develop a nomogram for predicting OS, and the DCAs indicated that the predictive performance of the nomogram was better than that of the clinical model.

Conclusion: For patients with advanced LC, CT radiomics score was an independent biomarker for estimating PR after IC. Moreover, the nomogram that incorporated radiomics features and clinicopathological factors performed better for individualized OS estimation.

Citing Articles

Clinical application of CT-based radiomics model in differentiation between laryngeal squamous cell carcinoma and squamous cell hyperplasia.

Cui F, Khodrog O, Liu W, Liu J, Yuan Q Front Med (Lausanne). 2024; 10:1337723.

PMID: 38274455 PMC: 10808460. DOI: 10.3389/fmed.2023.1337723.

References

Miyabe J, Hanamoto A, Tatsumi M, Hamasaki T, Takenaka Y, Nakahara S . Metabolic tumor volume of primary tumor predicts survival better than T classification in the larynx preservation approach. Cancer Sci. 2017; 108(10):2030-2038. PMC: 5623730. DOI: 10.1111/cas.13345. View

Akbaba S, Held T, Lang K, Hoerner-Rieber J, Zaoui K, Forster T . Salvage radiotherapy for recurrent hypopharyngeal and laryngeal squamous cell carcinoma (SCC) after first-line treatment with surgery alone: a 10-year single-centre experience. Radiat Oncol. 2019; 14(1):34. PMC: 6381740. DOI: 10.1186/s13014-019-1238-8. View

Wan L, Sun Z, Peng W, Wang S, Li J, Zhao Q . Selecting Candidates for Organ-Preserving Strategies After Neoadjuvant Chemoradiotherapy for Rectal Cancer: Development and Validation of a Model Integrating MRI Radiomics and Pathomics. J Magn Reson Imaging. 2022; 56(4):1130-1142. DOI: 10.1002/jmri.28108. View

Ahmed A, Gibbs P, Pickles M, Turnbull L . Texture analysis in assessment and prediction of chemotherapy response in breast cancer. J Magn Reson Imaging. 2012; 38(1):89-101. DOI: 10.1002/jmri.23971. View

Li C, Lu N, He Z, Tan Y, Liu Y, Chen Y . A Noninvasive Tool Based on Magnetic Resonance Imaging Radiomics for the Preoperative Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy in Breast Cancer. Ann Surg Oncol. 2022; 29(12):7685-7693. PMC: 9550709. DOI: 10.1245/s10434-022-12034-w. View

Yin X, Hadjiloucas S, Zhang Y, Tian Z . MRI radiogenomics for intelligent diagnosis of breast tumors and accurate prediction of neoadjuvant chemotherapy responses-a review. Comput Methods Programs Biomed. 2021; 214:106510. DOI: 10.1016/j.cmpb.2021.106510. View

Persigehl T, Lennartz S, Schwartz L . iRECIST: how to do it. Cancer Imaging. 2020; 20(1):2. PMC: 6942293. DOI: 10.1186/s40644-019-0281-x. View

Forastiere A, Ismaila N, Lewin J, Nathan C, Adelstein D, Eisbruch A . Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2017; 36(11):1143-1169. DOI: 10.1200/JCO.2017.75.7385. View

Lee M, Belfiglio M, Zeng J, Fleming C, Koyfman S, Joshi N . Primary Total Laryngectomy versus Organ Preservation for Locally Advanced T3/T4a Laryngeal Cancer. Laryngoscope. 2022; 133(5):1122-1131. DOI: 10.1002/lary.30254. View

10.

Stevanovic S, Greguric T, Pazanin L, Ivkic B, Geber A, Hadzavdic A . Diagnostic Accuracy of Preoperative CT and Endoscopy Staging in Early Laryngeal Cancer. Otolaryngol Head Neck Surg. 2022; 168(4):769-774. DOI: 10.1177/01945998221109819. View

11.

Masson I, Da-Ano R, Lucia F, Dore M, Castelli J, Goislard de Monsabert C . Statistical harmonization can improve the development of a multicenter CT-based radiomic model predictive of nonresponse to induction chemotherapy in laryngeal cancers. Med Phys. 2021; 48(7):4099-4109. DOI: 10.1002/mp.14948. View

12.

Zheng X, Xu S, Wu J . Cervical Cancer Imaging Features Associated With as a Risk Factor for Cerebral Neurovascular Metastases. Front Neurol. 2022; 13:905761. PMC: 9315067. DOI: 10.3389/fneur.2022.905761. View

13.

Li W, Zhang H, Ren L, Zou Y, Tian F, Ji X . Radiomics of dual-energy computed tomography for predicting progression-free survival in patients with early glottic cancer. Future Oncol. 2022; 18(15):1873-1884. DOI: 10.2217/fon-2021-1125. View

14.

Vos J, Elbers J, Krijgsman O, Traets J, Qiao X, van der Leun A . Neoadjuvant immunotherapy with nivolumab and ipilimumab induces major pathological responses in patients with head and neck squamous cell carcinoma. Nat Commun. 2021; 12(1):7348. PMC: 8695578. DOI: 10.1038/s41467-021-26472-9. View

15.

Toya R, Watakabe T, Murakami D, Matsuyama T, Saito T, Fukugawa Y . Concurrent Chemoradiotherapy With Docetaxel, Cisplatin, and 5-Fluorouracil for T3 N0 Glottic Carcinoma Without Vocal Cord Fixation. Anticancer Res. 2021; 42(1):205-209. DOI: 10.21873/anticanres.15474. View

16.

Tunali I, Tan Y, Gray J, Katsoulakis E, Eschrich S, Saller J . Hypoxia-Related Radiomics and Immunotherapy Response: A Multicohort Study of Non-Small Cell Lung Cancer. JNCI Cancer Spectr. 2021; 5(4). PMC: 8363765. DOI: 10.1093/jncics/pkab048. View

17.

Vos J, Zuur C, Smit L, de Boer J, Al-Mamgani A, van den Brekel M . [F]FDG-PET accurately identifies pathological response early upon neoadjuvant immune checkpoint blockade in head and neck squamous cell carcinoma. Eur J Nucl Med Mol Imaging. 2021; 49(6):2010-2022. PMC: 9016016. DOI: 10.1007/s00259-021-05610-x. View

18.

Janoray G, Pointreau Y, Garaud P, Chapet S, Alfonsi M, Sire C . Long-term Results of a Multicenter Randomized Phase III Trial of Induction Chemotherapy With Cisplatin, 5-fluorouracil, ± Docetaxel for Larynx Preservation. J Natl Cancer Inst. 2015; 108(4). DOI: 10.1093/jnci/djv368. View

19.

Chen Y, Wei K, Liu D, Xiang J, Wang G, Meng X . A Machine Learning Model for Predicting a Major Response to Neoadjuvant Chemotherapy in Advanced Gastric Cancer. Front Oncol. 2021; 11:675458. PMC: 8204104. DOI: 10.3389/fonc.2021.675458. View

20.

Li R, Ye L, Zhu Y, Ding H, Wang S, Ying H . Induction chemotherapy of modified docetaxel, cisplatin, 5-fluorouracil for laryngeal preservation in locally advanced hypopharyngeal squamous cell carcinoma. Head Neck. 2022; 44(9):2018-2029. DOI: 10.1002/hed.27119. View