Radiomics Facilitates Candidate Selection for Irradiation Stents Among Patients With Unresectable Pancreatic Cancer

• Published in: Frontiers in oncology 2019-09, Vol.9, p.973-973
• Main Authors: Zhou, Hai-Feng, Han, Yu-Qi, Lu, Jian, Wei, Jing-Wei, Guo, Jin-He, Zhu, Hai-Dong, Huang, Ming, Ji, Jian-Song, Lv, Wei-Fu, Chen, Li, Zhu, Guang-Yu, Jin, Zhi-Cheng, Tian, Jie, Teng, Gao-Jun
• Format: Article
• Language: English
• Subjects: irradiation stent; malignant biliary obstruction; Oncology; pancreatic cancer; radiomics; survival
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2019.00973

Purpose: To develop a model to select appropriate candidates for irradiation stent placement among patients with unresectable pancreatic cancer with malignant biliary obstruction (UPC-MBO). Methods: This retrospective study included 106 patients treated with an irradiation stent for UPC-MBO. These patients were randomly divided into a training group (74 patients) and a validation group (32 patients). A clinical model for predicting restenosis-free survival (RFS) was developed with clinical predictors selected by univariate and multivariate analyses. After integrating the radiomics signature, a combined model was constructed to predict RFS. The predictive performance was evaluated with the concordance index (C-index) in both the training and validation groups. The median risk score of progression in the training group was used to divide patients into high- and low-risk subgroups. Results: Radiomics features were integrated with clinical predictors to develop a combined model. The predictive performance was better in the combined model (C-index, 0.791 and 0.779 in the training and validation groups, respectively) than in the clinical model (C-index, 0.673 and 0.667 in the training and validation groups, respectively). According to the median risk score of 1.264, the RFS was significantly different between the high- and low-risk groups ( p < 0.001 for the training group, and p = 0.016 for the validation group). Conclusions: The radiomics-based model had good performance for RFS prediction in patients with UPC-MBO who received an irradiation stent. Patients with slow progression should consider undergoing irradiation stent placement for a longer RFS.