Abstract
Objectives: This study aimed to explore the predictive value of MRI-based radiomic model for progression-free survival (PFS) in nonmetastatic nasopharyngeal carcinoma (NPC).Methods: A total of 327 nonmetastatic NPC patients [training cohort (n = 230) and validation cohort (n = 97)] were enrolled. The clinical and MRI data were collected. The least absolute shrinkage selection operator (LASSO) and recursive feature elimination (RFE) were used to select radiomic features. Five models [Model 1: clinical data, Model 2: overall stage, Model 3: radiomics, Model 4: radiomics + overall stage, Model 5: radiomics + overall stage + Epstein–Barr virus (EBV) DNA] were constructed. The prognostic performances of these models were evaluated by Harrell's concordance index (C-index). The Kaplan–Meier method was applied for the survival analysis.Results: Model 5 incorporating radiomics, overall stage, and EBV DNA yielded the highest C-indices for predicting PFS in comparison with Model 1, Model 2, Model 3, and Model 4 (training cohorts: 0.805 vs. 0.766 vs. 0.749 vs. 0.641 vs. 0.563, validation cohorts: 0.874 vs. 0.839 vs. 836 vs. 0.689 vs. 0.456). The survival curve showed that the high-risk group yielded a lower PFS than the low-risk group.Conclusions: The model incorporating radiomics, overall stage, and EBV DNA showed better performance for predicting PFS in nonmetastatic NPC patients.
Highlights
Nasopharyngeal carcinoma (NPC) has obvious geographical distribution characteristics, especially in the south of China [1]
This study aimed to explore the predictive value of MRI-based radiomic model for progression-free survival (PFS) in nonmetastatic nasopharyngeal carcinoma (NPC)
Model 5 incorporating radiomics, overall stage, and Epstein–Barr virus (EBV) DNA yielded the highest C-indices for predicting PFS in comparison with Model 1, Model 2, Model 3, and Model 4
Summary
Nasopharyngeal carcinoma (NPC) has obvious geographical distribution characteristics, especially in the south of China [1]. Only 72.9% of patients with locoregionally advanced NPC have a 2-year progression-free survival (PFS) [2]. It is very important to improve the outcome of those patients. Individualized treatment based on precise stratification of PFS can improve the prognosis of NPC patients. This has led to a search for PFS prognostic factors, including clinical and image biomarkers. The American Joint Committee on Cancer/Union for International Cancer Control TNM staging system has been widely used to predict PFS for patients with NPC. The latest eighth edition failed to accurately differentiate the PFS of stage II and III NPCs [4]
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