CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma
Abstract Chemoradiation is a common therapeutic regimen for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). However, not all patients benefit from chemotherapy, especially patients with low-risk characteristics. We aim to develop and validate a prognostic and pre...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-06-01
|
| Series: | npj Precision Oncology |
| Online Access: | https://doi.org/10.1038/s41698-023-00404-w |
| _version_ | 1827608119480418304 |
|---|---|
| author | Bolin Song Kailin Yang Vidya Sankar Viswanathan Xiangxue Wang Jonathan Lee Sarah Stock Pingfu Fu Cheng Lu Shlomo Koyfman James S. Lewis Anant Madabhushi |
| author_facet | Bolin Song Kailin Yang Vidya Sankar Viswanathan Xiangxue Wang Jonathan Lee Sarah Stock Pingfu Fu Cheng Lu Shlomo Koyfman James S. Lewis Anant Madabhushi |
| author_sort | Bolin Song |
| collection | DOAJ |
| description | Abstract Chemoradiation is a common therapeutic regimen for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). However, not all patients benefit from chemotherapy, especially patients with low-risk characteristics. We aim to develop and validate a prognostic and predictive radiomic image signature (pRiS) to inform survival and chemotherapy benefit using computed tomography (CT) scans from 491 stage I and II HPV-associated OPSCC, which were divided into three cohorts D1–D3. The prognostic performance of pRiS was evaluated on two test sets (D2, n = 162; D3, n = 269) using concordance index. Patients from D2 and D3 who received either radiotherapy alone or chemoradiation were used to validate pRiS as predictive of added benefit of chemotherapy. Seven features were selected to construct pRiS, which was found to be prognostic of overall survival (OS) on univariate analysis in D2 (hazard ratio [HR] = 2.14, 95% confidence interval [CI], 1.1–4.16, p = 0.02) and D3 (HR = 2.74, 95% CI, 1.34–5.62, p = 0.006). Chemotherapy was associated with improved OS for high-pRiS patients in D2 (radiation vs chemoradiation, HR = 4.47, 95% CI, 1.73–11.6, p = 0.002) and D3 (radiation vs chemoradiation, HR = 2.99, 95% CI, 1.04–8.63, p = 0.04). In contrast, chemotherapy did not improve OS for low-pRiS patients, which indicates these patients did not derive additional benefit from chemotherapy and could be considered for treatment de-escalation. The proposed radiomic signature was prognostic of patient survival and informed benefit from chemotherapy for stage I and II HPV-associated OPSCC patients. |
| first_indexed | 2024-03-09T07:05:19Z |
| format | Article |
| id | doaj.art-9af0373870a44d73b434824de5ed0858 |
| institution | Directory Open Access Journal |
| issn | 2397-768X |
| language | English |
| last_indexed | 2024-03-09T07:05:19Z |
| publishDate | 2023-06-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Precision Oncology |
| spelling | doaj.art-9af0373870a44d73b434824de5ed08582023-12-03T09:39:57ZengNature Portfolionpj Precision Oncology2397-768X2023-06-017111310.1038/s41698-023-00404-wCT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinomaBolin Song0Kailin Yang1Vidya Sankar Viswanathan2Xiangxue Wang3Jonathan Lee4Sarah Stock5Pingfu Fu6Cheng Lu7Shlomo Koyfman8James S. Lewis9Anant Madabhushi10Center for Computational Imaging and Personalized Diagnostics, Emory UniversityDepartment of Radiation Oncology, Taussig Cancer Center, Cleveland ClinicCenter for Computational Imaging and Personalized Diagnostics, Emory UniversitySchool of Automation, Nanjing University of Information Science and TechnologyImaging Institute, Cleveland ClinicImaging Institute, Cleveland ClinicDepartment of Population and Quantitative Health Sciences, Case Western Reserve UniversityCenter for Computational Imaging and Personalized Diagnostics, Emory UniversityDepartment of Radiation Oncology, Taussig Cancer Center, Cleveland ClinicDepartment of Pathology, Microbiology, and Immunology, Vanderbilt University Medical CenterCenter for Computational Imaging and Personalized Diagnostics, Emory UniversityAbstract Chemoradiation is a common therapeutic regimen for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). However, not all patients benefit from chemotherapy, especially patients with low-risk characteristics. We aim to develop and validate a prognostic and predictive radiomic image signature (pRiS) to inform survival and chemotherapy benefit using computed tomography (CT) scans from 491 stage I and II HPV-associated OPSCC, which were divided into three cohorts D1–D3. The prognostic performance of pRiS was evaluated on two test sets (D2, n = 162; D3, n = 269) using concordance index. Patients from D2 and D3 who received either radiotherapy alone or chemoradiation were used to validate pRiS as predictive of added benefit of chemotherapy. Seven features were selected to construct pRiS, which was found to be prognostic of overall survival (OS) on univariate analysis in D2 (hazard ratio [HR] = 2.14, 95% confidence interval [CI], 1.1–4.16, p = 0.02) and D3 (HR = 2.74, 95% CI, 1.34–5.62, p = 0.006). Chemotherapy was associated with improved OS for high-pRiS patients in D2 (radiation vs chemoradiation, HR = 4.47, 95% CI, 1.73–11.6, p = 0.002) and D3 (radiation vs chemoradiation, HR = 2.99, 95% CI, 1.04–8.63, p = 0.04). In contrast, chemotherapy did not improve OS for low-pRiS patients, which indicates these patients did not derive additional benefit from chemotherapy and could be considered for treatment de-escalation. The proposed radiomic signature was prognostic of patient survival and informed benefit from chemotherapy for stage I and II HPV-associated OPSCC patients.https://doi.org/10.1038/s41698-023-00404-w |
| spellingShingle | Bolin Song Kailin Yang Vidya Sankar Viswanathan Xiangxue Wang Jonathan Lee Sarah Stock Pingfu Fu Cheng Lu Shlomo Koyfman James S. Lewis Anant Madabhushi CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma npj Precision Oncology |
| title | CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma |
| title_full | CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma |
| title_fullStr | CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma |
| title_full_unstemmed | CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma |
| title_short | CT radiomic signature predicts survival and chemotherapy benefit in stage I and II HPV-associated oropharyngeal carcinoma |
| title_sort | ct radiomic signature predicts survival and chemotherapy benefit in stage i and ii hpv associated oropharyngeal carcinoma |
| url | https://doi.org/10.1038/s41698-023-00404-w |
| work_keys_str_mv | AT bolinsong ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT kailinyang ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT vidyasankarviswanathan ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT xiangxuewang ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT jonathanlee ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT sarahstock ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT pingfufu ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT chenglu ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT shlomokoyfman ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT jamesslewis ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma AT anantmadabhushi ctradiomicsignaturepredictssurvivalandchemotherapybenefitinstageiandiihpvassociatedoropharyngealcarcinoma |