Abstract
PurposeThis study aimed to develop a nomogram model based on multiparametric magnetic resonance imaging (MRI) radiomics features, clinicopathological characteristics, and blood parameters to predict the progression-free survival (PFS) of patients with nasopharyngeal carcinoma (NPC).MethodsA total of 462 patients with pathologically confirmed nonkeratinizing NPC treated at Sichuan Cancer Hospital were recruited from 2015 to 2019 and divided into training and validation cohorts at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) algorithm was used for radiomics feature dimension reduction and screening in the training cohort. Rad-score, age, sex, smoking and drinking habits, Ki-67, monocytes, monocyte ratio, and mean corpuscular volume were incorporated into a multivariate Cox proportional risk regression model to build a multifactorial nomogram. The concordance index (C-index) and decision curve analysis (DCA) were applied to estimate its efficacy.ResultsNine significant features associated with PFS were selected by LASSO and used to calculate the rad-score of each patient. The rad-score was verified as an independent prognostic factor for PFS in NPC. The survival analysis showed that those with lower rad-scores had longer PFS in both cohorts (p < 0.05). Compared with the tumor–node–metastasis staging system, the multifactorial nomogram had higher C-indexes (training cohorts: 0.819 vs. 0.610; validation cohorts: 0.820 vs. 0.602). Moreover, the DCA curve showed that this model could better predict progression within 50% threshold probability.ConclusionA nomogram that combined MRI-based radiomics with clinicopathological characteristics and blood parameters improved the ability to predict progression in patients with NPC.
Highlights
Nasopharyngeal carcinoma (NPC) is a malignant tumor in the mucous membrane of the nasopharynx
This study aimed to develop a nomogram model based on multiparametric magnetic resonance imaging (MRI) radiomics features, clinicopathological characteristics, and blood parameters to predict the progression-free survival (PFS) of patients with nasopharyngeal carcinoma (NPC)
Nine significant features associated with PFS were selected by least absolute shrinkage and selection operator (LASSO) and used to calculate the rad-score of each patient
Summary
Nasopharyngeal carcinoma (NPC) is a malignant tumor in the mucous membrane of the nasopharynx. Intensity-modulated radiotherapy (IMRT) significantly improved the prognosis of NPC, some patients still experience progression [4, 5]. The risk assessment of NPC is mainly determined by the tumor–node– metastasis (TNM) staging system, which only has 61% accuracy for predicting the local recurrence of NPC [6]. While it incorporates local tumor invasion, positive lymph nodes, and distant metastases, TNM cannot explain the temporal and spatial heterogeneity or changes in the internal and external environments of tumor cells. It is urgent to identify more representative and comprehensive biomarkers to predict NPC prognosis
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