论著摘要 |【CT】来自治疗前CT扫描的成像特征与用立体定向体部放射治疗的非小细胞肺癌患者的临床结果相关(双语版)

2017-08-24 11:44:13 admin 183

Imaging features from pre-treatment CT scans are associated with clinical outcomes in non-small-cell lung cancer patients treated with stereotactic body radiotherapy.

发表日期:2017.5.2      来源:Med Phys.

作者:Li Q1,2Kim J3Balagurunathan Y2Liu Y1Latifi K4Stringfield O2Garcia A2Moros EG2,4Dilling TJ4Schabath MB5Ye Z1Gillies RJ2

作者介绍:

  1. Department of Radiology, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.

  2. Department of Cancer Imaging and Metabolism, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.

  3. Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.

  4. Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.

  5. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.


目的

为了研究治疗前断层CT扫描的成像特征是否与非小细胞肺癌(NSCLC)患者立体定向放射治疗(SBRT)之后的总生存期(OS),无复发生存期(RFS)和局部无复发生存期(LR-RFS)相关。

To investigate whether imaging features from pretreatment planning CT scans are associated with overall survival (OS), recurrence-free survival (RFS), and loco-regional recurrence-free survival (LR-RFS) after stereotactic body radiotherapy (SBRT) among nonsmall-cell lung cancer (NSCLC) patients.

患者和方法

本研究共有92例(中位年龄:73岁),I期或IIA期非小细胞肺癌患者。标准治疗为5次总剂量为50 Gy。除了临床特征外,基于点刻度(最多5分)手动对24个“语义”图像特征进行评分,并且基于整个肿瘤分割提取了219个计算机衍生的“放射组学”特征。使用Cox比例风险模型和Harrell's C指数进行统计学分析,并根据24个月的生存或复发状态,通过二分法患者进行十次交叉验证评估最终预后模型的鲁棒性。

A total of 92 patients (median age: 73 yr) with stage I or IIA NSCLC were qualified for this study. A total dose of 50 Gy in five fractions was the standard treatment. Besides clinical characteristics, 24 "semantic" image features were manually scored based on a point scale (up to 5) and 219 computer-derived "radiomic" features were extracted based on whole tumor segmentation. Statistical analysis was performed using Cox proportional hazards model and Harrell's C-index, and the robustness of final prognostic model was assessed using tenfold cross validation by dichotomizing patients according to the survival or recurrence status at 24 months.

结果

两年OS,RFS和LR-RFS分别为69.95%,41.3%和51.85%。在临床模型中添加成像特征时,Harrell’C指数有所改善。 OS的模型包括东方肿瘤协作组(ECOG)的体能状态[危害比(HR)= 2.78,95%置信区间(CI):1.37-5.65],胸膜收缩(HR = 0.27,95%CI:0.08- 0.92),F2(短轴×最长直径,HR = 1.72,95%CI:1.21-2.44)和F186(Hist-Energy-L1,HR = 1.27,95%CI:1.00-1.61); RFS的预后模型包含血管附着(HR = 2.13,95%CI:1.24-3.64)和F2(HR = 1.69,95%CI:1.33-2.15); LR-RFS模型包含ECOG体能状态(HR = 2.01,95%CI:1.12-3.60)和F2(HR = 1.67,95%CI:1.29-2.18)。

Two-year OS, RFS and LR-RFS were 69.95%, 41.3%, and 51.85%, respectively. There was an improvement of Harrell's C-index when adding imaging features to a clinical model. The model for OS contained the Eastern Cooperative Oncology Group (ECOG) performance status [Hazard Ratio (HR) = 2.78, 95% Confidence Interval (CI): 1.37-5.65], pleural retraction (HR = 0.27, 95% CI: 0.08-0.92), F2 (short axis × longest diameter, HR = 1.72, 95% CI: 1.21-2.44) and F186 (Hist-Energy-L1, HR = 1.27, 95% CI: 1.00-1.61); The prognostic model for RFS contained vessel attachment (HR = 2.13, 95% CI: 1.24-3.64) and F2 (HR = 1.69, 95% CI: 1.33-2.15); and the model for LR-RFS contained the ECOG performance status (HR = 2.01, 95% CI: 1.12-3.60) and F2 (HR = 1.67, 95% CI: 1.29-2.18).

结论

来自断层CT的成像特征表现出立体定向放射治疗后复发的预后价值,可能有助于患者分层。

Imaging features derived from planning CT demonstrate prognostic value for recurrence following SBRT treatment, and might be helpful in patient stratification.

关键词

计算机断层扫描,图像特征,影像组学,语义,立体定向放射治疗(SBRT),生存

computed tomography; image features; radiomics; semantics; stereotactic body radiotherapy (SBRT); survival


阅读原文:10.1002/mp.12309


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