1. Radiomics Facilitates Candidate Selection for Irradiation Stents Among Patients With Unresectable Pancreatic Cancer
- Author
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Hai-Feng Zhou, Yu-Qi Han, Jian Lu, Jing-Wei Wei, Jin-He Guo, Hai-Dong Zhu, Ming Huang, Jian-Song Ji, Wei-Fu Lv, Li Chen, Guang-Yu Zhu, Zhi-Cheng Jin, Jie Tian, and Gao-Jun Teng
- Subjects
0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,pancreatic cancer ,irradiation stent ,lcsh:RC254-282 ,survival ,03 medical and health sciences ,0302 clinical medicine ,Radiomics ,Pancreatic cancer ,medicine ,malignant biliary obstruction ,Original Research ,Unresectable Pancreatic Cancer ,Framingham Risk Score ,business.industry ,Univariate ,Stent ,Retrospective cohort study ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,030104 developmental biology ,Oncology ,radiomics ,030220 oncology & carcinogenesis ,Radiology ,business - Abstract
Purpose: To develop a model to select appropriate candidates for irradiation stent placement among patients with unresectable pancreatic cancer with malignant biliary obstruction (UPC-MBO).Methods: This retrospective study included 106 patients treated with an irradiation stent for UPC-MBO. These patients were randomly divided into a training group (74 patients) and a validation group (32 patients). A clinical model for predicting restenosis-free survival (RFS) was developed with clinical predictors selected by univariate and multivariate analyses. After integrating the radiomics signature, a combined model was constructed to predict RFS. The predictive performance was evaluated with the concordance index (C-index) in both the training and validation groups. The median risk score of progression in the training group was used to divide patients into high- and low-risk subgroups.Results: Radiomics features were integrated with clinical predictors to develop a combined model. The predictive performance was better in the combined model (C-index, 0.791 and 0.779 in the training and validation groups, respectively) than in the clinical model (C-index, 0.673 and 0.667 in the training and validation groups, respectively). According to the median risk score of 1.264, the RFS was significantly different between the high- and low-risk groups (p < 0.001 for the training group, and p = 0.016 for the validation group).Conclusions: The radiomics-based model had good performance for RFS prediction in patients with UPC-MBO who received an irradiation stent. Patients with slow progression should consider undergoing irradiation stent placement for a longer RFS.
- Published
- 2019
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