1. External validation of nodal failure prediction models including radiomics in head and neck cancer.
- Author
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Zhai TT, Wesseling F, Langendijk JA, Shi Z, Kalendralis P, van Dijk LV, Hoebers F, Steenbakkers RJHM, Dekker A, Wee L, and Sijtsema NM
- Subjects
- Aged, Antineoplastic Agents, Immunological therapeutic use, Cetuximab therapeutic use, Cisplatin therapeutic use, Cohort Studies, Confidence Intervals, Female, Humans, Laryngeal Neoplasms diagnostic imaging, Laryngeal Neoplasms pathology, Laryngeal Neoplasms radiotherapy, Lymph Nodes diagnostic imaging, Male, Middle Aged, Models, Biological, Mouth Neoplasms diagnostic imaging, Mouth Neoplasms pathology, Mouth Neoplasms radiotherapy, Pharyngeal Neoplasms diagnostic imaging, Pharyngeal Neoplasms pathology, Pharyngeal Neoplasms radiotherapy, Radiation-Sensitizing Agents therapeutic use, Squamous Cell Carcinoma of Head and Neck diagnostic imaging, Treatment Failure, Lymph Nodes pathology, Lymph Nodes radiation effects, Squamous Cell Carcinoma of Head and Neck pathology, Squamous Cell Carcinoma of Head and Neck radiotherapy
- Abstract
Purpose: To externally validate the previously published pre-treatment prediction models for lymph nodes failure after definitive radiotherapy in head and neck squamous cell carcinoma (HNSCC) patients., Materials and Methods: This external validation cohort consisted of 143 node positive HNSCC patients treated between July 2007 and June 2016 by curative radiotherapy with or without either cisplatin or cetuximab. Imaging and pathology reports during follow-up were analyzed to indicate persisting or recurring nodes. The previously established clinical, radiomic and combined models were validated on this cohort by assessing the concordance index (c-index) and model calibration., Results: Overall 113 patients with 374 pLNs were suitable for final analysis. There were 20 (5.3%) nodal failures from 15 patients after a median follow-up of 36.1 months. Baseline characteristics and radiomic features were comparable to the training cohort. Both the radiomic model (Least-axis-length of lymph node (LALLN) and correlation of gray level co-occurrence matrix (Corre-GLCM)) and the combined model (T stage, gender, WHO performance score, LALLN and Corre-GLCM) showed good agreement between predicted and observed nodal control probabilities. The radiomic (c-index: 0.71; 95% confidence interval (CI): 0.59-0.84) and combined (c-index: 0.71; 95% CI: 0.59-0.82) models performed better than the clinical model (c-index: 0.57; 95% CI: 0.47-0.68) on this cohort, with a significant difference between the combined and clinical models (z-score test: p = 0.005)., Conclusion: The combined model including clinical and radiomic features was externally validated and proved useful to predict nodal failures and could be helpful to guide treatment choices before and after curative radiation treatment for node positive HNSCC patients., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2021
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