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

• Published in: Radiotherapy and oncology 2023-12, Vol.189, p.109938-109938, Article 109938
• Main Authors: Lin, Chia-Hsin, Yan, Jiun-Lin, Yap, Wing-Keen, Kang, Chung-Jan, Chang, Yun-Chen, Tsai, Tsung-You, Chang, Kai-Ping, Liao, Chun-Ta, Hsu, Cheng-Lung, Chou, Wen-Chi, Wang, Hung-Ming, Huang, Pei-Wei, Fan, Kang-Hsing, Huang, Bing-Shen, Tung-Chieh Chang, Joseph, Tu, Shu-Ju, Lin, Chien-Yu
• Format: Article
• Language: English
• Subjects: Biomarker; Laryngeal and hypopharyngeal cancer; Lymphocyte; Prognosis; Radiomics; Radiotherapy
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2023.109938

•CT-simulation based radiomic models during radiotherapy carry significant prognostic value for both progression-free survival and overall survival in patients with laryngeal and hypopharyngeal cancer.•Mid-radiotherapy peritumoral and intratumoral radiomic models were superior to AJCC staging and tumor volume.•Mid-radiotherapy peritumoral and intratumoral radiomic models were superior to pre-radiotherapy intratumoral radiomic models. 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). 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. 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. 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.