基于机器学习的非小细胞肺癌新辅助化疗后病理反应和预后预测:一项回顾性研究

IF 3.3 3区 医学 Q2 ONCOLOGY
Zhaojuan Jiang , Qingwan Li , Jinqiu Ruan , Yanli Li , Dafu Zhang , Yongzhou Xu , Yuting Liao , Xin Zhang , Depei Gao , Zhenhui Li
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引用次数: 0

摘要

新辅助化疗对非小细胞肺癌(NSCLC)患者的疗效参差不齐,但却缺乏可靠的非侵入性预测指标。本研究旨在建立一个放射组学模型,预测非小细胞肺癌的病理完全反应和新辅助化疗后的生存率。回顾性数据收集涉及130名接受新辅助化疗和手术的NSCLC患者。患者被随机分为训练集和独立测试集。从化疗前CT图像的瘤内和瘤周区域提取了九个放射组学特征。构建了一个自动编码器模型,并对其性能进行了评估。X-tile软件根据预测概率将患者分为高风险组和低风险组,并对不同风险组患者的生存率和术后辅助化疗的作用进行了研究。该模型的接收者操作特征曲线下面积为 0.874(训练集)和 0.876(测试集)。接受者操作特征曲线下面积值越大,模型性能越好。校准曲线和决策曲线分析表明,模型校准效果极佳(Hosmer-Lemeshow 检验,=0.763,-值越大,模型拟合效果越好),具有潜在的临床适用性。生存期分析表明,不同风险组的总生存期(= 0.011)和无病生存期(= 0.017)存在显著差异。辅助化疗能明显提高低风险组的生存率(= 0.041),但不能提高高风险组的生存率(= 0.56)。这项研究首次成功地利用瘤内和瘤周放射组学特征预测了NSCLC新辅助化疗后的病理完全缓解以及患者的生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Machine Learning-Based Prediction of Pathological Responses and Prognosis After Neoadjuvant Chemotherapy for Non–Small-Cell Lung Cancer: A Retrospective Study

Background

Neoadjuvant chemotherapy has variable efficacy in patients with non–small-cell lung cancer (NSCLC), yet reliable noninvasive predictive markers are lacking. This study aimed to develop a radiomics model predicting pathological complete response and postneoadjuvant chemotherapy survival in NSCLC.

Materials and Methods

Retrospective data collection involved 130 patients with NSCLC who underwent neoadjuvant chemotherapy and surgery. Patients were randomly divided into training and independent testing sets. Nine radiomics features from prechemotherapy computed tomography (CT) images were extracted from intratumoral and peritumoral regions. An auto-encoder model was constructed, and its performance was evaluated. X-tile software classified patients into high and low-risk groups based on their predicted probabilities. survival of patients in different risk groups and the role of postoperative adjuvant chemotherapy were examined.

Results

The model demonstrated area under the receiver operating characteristic (ROC) curve of 0.874 (training set) and 0.876 (testing set). The larger the area under curve (AUC), the better the model performance. Calibration curve and decision curve analysis indicated excellent model calibration (Hosmer–Lemeshow test, P = .763, the higher the P-value, the better the model fit) and potential clinical applicability. Survival analysis revealed significant differences in overall survival (P = .011) and disease-free survival (P = .017) between different risk groups. Adjuvant chemotherapy significantly improved survival in the low-risk group (P = .041) but not high-risk group (P = 0.56).

Conclusion

This study represents the first successful prediction of pathological complete response achievement after neoadjuvant chemotherapy for NSCLC, as well as the patients’ survival, utilizing intratumoral and peritumoral radiomics features.

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来源期刊
Clinical lung cancer
Clinical lung cancer 医学-肿瘤学
CiteScore
7.00
自引率
2.80%
发文量
159
审稿时长
24 days
期刊介绍: Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
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