Nomograms combining clinical factors and apparent diffusion coefficient to predict downstaging and progression-free survival after concurrent chemoradiotherapy in patients with cervical cancer

• Published in: Acta radiologica (1987) 2024-11, Vol.65 (11), p.1430-1439
• Main Authors: Fan, Jiawei, Li, Wenfei, Cheng, Mengyu, Wang, Zhehan, Wang, Zhanqiu, Chen, Tao, Gu, Tao
• Format: Article
• Language: English
• Subjects: Adult; Aged; Chemoradiotherapy - methods; Diffusion Magnetic Resonance Imaging - methods; Female; Humans; Middle Aged; Neoplasm Staging; Nomograms; Prognosis; Progression-Free Survival; Retrospective Studies; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - therapy
• ISSN: 0284-1851; 1600-0455; 1600-0455
• DOI: 10.1177/02841851241283042

Background Concurrent chemoradiotherapy (CCRT) is used as the primary treatment modality for currently limited cervical cancer and lacks non-invasive quantitative parameters to assess clinical outcomes of treatment for cervical cancer treatment. Purpose To develop nomograms based on clinical prognostic factors and apparent diffusion coefficient (ADC) in predicting downstaging and progression-free survival (PFS) after CCRT for cervical cancer. Material and Methods X-tile was used to calculate the optimal threshold for ΔADCmean(%) for prognostic stratification. Kaplan–Meier curves were used to calculate the difference in PFS between high- and low-risk groups. Univariate and multivariate Cox proportional risk regression models were used to identify clinical and radiological risk factors for prognosis and construct a prognostic nomogram model. Results ΔADCmean(%) was significantly correlated with tumor downstaging; the area under the receiver operating characteristic curve (AUC) was 0.868. X-tile showed that the optimal threshold for ΔADCmean(%) to diagnose prognosis was 40.8. Kaplan–Meier curves showed that the low-risk population in the training group had significantly longer PFS within 3 years (P