Prognostic value of interim CT-based peritumoral and intratumoral radiomics in laryngeal and hypopharyngeal cancer patients undergoing definitive radiotherapy

Chia-Hsin Lin; Jiun-Lin Yan; Wing-Keen Yap; Chung-Jan Kang; Yun-Chen Chang; Tsung-You Tsai; Kai-Ping Chang; Chun-Ta Liao; Cheng-Lung Hsu; Wen-Chi Chou; Hung-Ming Wang; Pei-Wei Huang; Kang-Hsing Fan; Bing-Shen Huang; Joseph Tung-Chieh Chang; Shu-Ju Tu; Chien-Yu Lin

doi:10.1016/j.radonc.2023.109938

Prognostic value of interim CT-based peritumoral and intratumoral radiomics in laryngeal and hypopharyngeal cancer patients undergoing definitive radiotherapy

Radiother Oncol. 2023 Dec:189:109938. doi: 10.1016/j.radonc.2023.109938. Epub 2023 Oct 6.

Authors

Chia-Hsin Lin¹, Jiun-Lin Yan², Wing-Keen Yap³, Chung-Jan Kang⁴, Yun-Chen Chang⁵, Tsung-You Tsai⁶, Kai-Ping Chang⁷, Chun-Ta Liao⁸, Cheng-Lung Hsu⁹, Wen-Chi Chou¹⁰, Hung-Ming Wang¹¹, Pei-Wei Huang¹², Kang-Hsing Fan¹³, Bing-Shen Huang¹⁴, Joseph Tung-Chieh Chang¹⁵, Shu-Ju Tu¹⁶, Chien-Yu Lin¹⁷

Affiliations

¹ Proton and Radiation Therapy Center, Chang Gung Memorial Hospital-Linkou Medical Center, Department of Radiation Oncology, Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
² Department of Neurosurgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
³ Proton and Radiation Therapy Center, Chang Gung Memorial Hospital-Linkou Medical Center, Department of Radiation Oncology, Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
⁵ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
⁹ Department of Hematology-Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
¹⁰ Department of Hematology-Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
¹¹ Department of Hematology-Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
¹² Department of Hematology-Oncology, Chang Gung Memorial Hospital, Medical College of Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
¹³ Department of Radiation Oncology, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan. Electronic address: [email protected].
¹⁴ Proton and Radiation Therapy Center, Chang Gung Memorial Hospital-Linkou Medical Center, Department of Radiation Oncology, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].
¹⁵ Proton and Radiation Therapy Center, Chang Gung Memorial Hospital-Linkou Medical Center, Department of Radiation Oncology, Chang Gung University, Taoyuan, Taiwan; Department of Radiation Oncology, Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, China. Electronic address: [email protected].
¹⁶ Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: [email protected].
¹⁷ Proton and Radiation Therapy Center, Chang Gung Memorial Hospital-Linkou Medical Center, Department of Radiation Oncology, Chang Gung University, Taoyuan, Taiwan. Electronic address: [email protected].

PMID: 37806562
DOI: 10.1016/j.radonc.2023.109938

Abstract

Background and purpose: We aimed to investigate the prognostic value of peritumoral and intratumoral computed tomography (CT)-based radiomics during the course of radiotherapy (RT) in patients with laryngeal and hypopharyngeal cancer (LHC).

Materials and methods: A total of 92 eligible patients were 1:1 randomly assigned into training and validation cohorts. Pre-RT and mid-RT radiomic features were extracted from pre-treatment and interim CT. LASSO-Cox regression was used for feature selection and model construction. Time-dependent area under the receiver operating curve (AUC) analysis was applied to evaluate the models' prognostic performances. Risk stratification ability on overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method and Cox regression. The associations between radiomics and clinical parameters as well as circulating lymphocyte counts were also evaluated.

Results: The mid-RT peritumoral (AUC: 0.77) and intratumoral (AUC: 0.79) radiomic models yielded better performance for predicting OS than the pre-RT intratumoral model (AUC: 0.62) in validation cohort. This was confirmed by Kaplan-Meier analysis, in which risk stratification depended on the mid-RT peritumoral (p = 0.009) and intratumoral (p = 0.003) radiomics could be improved for OS, in comparison to the pre-RT intratumoral radiomics (p = 0.199). Multivariate analysis identified mid-RT peritumoral and intratumoral radiomic models as independent prognostic factors for both OS and PFS. Mid-RT peritumoral and intratumoral radiomics were correlated with treatment-related lymphopenia.

Conclusion: Mid-RT peritumoral and intratumoral radiomic models are promising image biomarkers that could have clinical utility for predicting OS and PFS in patients with LHC treated with RT.

Keywords: Biomarker; Laryngeal and hypopharyngeal cancer; Lymphocyte; Prognosis; Radiomics; Radiotherapy.

Publication types

Randomized Controlled Trial

MeSH terms

Humans
Hypopharyngeal Neoplasms* / diagnostic imaging
Hypopharyngeal Neoplasms* / radiotherapy
Laryngeal Neoplasms* / diagnostic imaging
Laryngeal Neoplasms* / radiotherapy
Prognosis
Retrospective Studies
Tomography, X-Ray Computed / methods