Delta magnetic resonance imaging radiomics features‑based nomogram predicts long‑term efficacy after induction chemotherapy in locoregionally advanced nasopharyngeal carcinoma

Oral Oncol. 2024 Oct:157:106987. doi: 10.1016/j.oraloncology.2024.106987. Epub 2024 Aug 10.

Abstract

Purpose: To establish and validate a delta-radiomics-based model for predicting progression-free survival (PFS) in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) following induction chemotherapy (IC).

Methods and materials: A total of 250 LA-NPC patients (training cohort: n = 145; validation cohort: n = 105) were enrolled. Radiomic features were extracted from MRI scans taken before and after IC, and changes in these features were calculated. Following feature selection, a delta-radiomics signature was constructed using LASSO-Cox regression analysis. A prognostic nomogram incorporating independent clinical indicators and the delta-radiomics signature was developed and assessed for calibration and discrimination. Risk stratification by the nomogram was evaluated using Kaplan-Meier methods.

Results: The delta-radiomics signature, consisting of 12 features, was independently associated with prognosis. The nomogram, integrating the delta-radiomics signature and clinical factors demonstrated excellent calibration and discrimination. The model achieved a Harrell's concordance index (C-index) of 0.848 in the training cohort and 0.820 in the validation cohort. Risk stratification identified two groups with significantly different PFS rates. The three-year PFS for high-risk patients who received concurrent chemoradiotherapy (CCRT) or radiotherapy plus adjuvant chemotherapy (RT+AC) after IC was significantly higher than for those who received RT alone, reaching statistical significance. In contrast, for low-risk patients, the three-year PFS after IC was slightly higher for those who received CCRT or RT+AC compared to those who received RT alone; however, this difference did not reach statistical significance.

Conclusions: Our delta MRI-based radiomics model could be useful for predicting PFS and may guide subsequent treatment decisions after IC in LA-NPC.

Keywords: Chemoradiotherapy; Delta-radiomics; Magnetic resonance imaging; Nasopharyngeal carcinoma; Nomogram.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Induction Chemotherapy* / methods
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma* / diagnostic imaging
  • Nasopharyngeal Carcinoma* / drug therapy
  • Nasopharyngeal Carcinoma* / mortality
  • Nasopharyngeal Carcinoma* / radiotherapy
  • Nasopharyngeal Neoplasms* / diagnostic imaging
  • Nasopharyngeal Neoplasms* / drug therapy
  • Nasopharyngeal Neoplasms* / mortality
  • Nasopharyngeal Neoplasms* / radiotherapy
  • Nomograms*
  • Prognosis
  • Radiomics*
  • Treatment Outcome