Prognostic value of interim CT-based peritumoral and intratumoral radiomics in laryngeal and hypopharyngeal cancer patients undergoing definitive radiotherapy

Radiother Oncol. 2023 Dec:189:109938. doi: 10.1016/j.radonc.2023.109938. Epub 2023 Oct 6.


Background and purpose: We aimed to investigate the prognostic value of peritumoral and intratumoral computed tomography (CT)-based radiomics during the course of radiotherapy (RT) in patients with laryngeal and hypopharyngeal cancer (LHC).

Materials and methods: A total of 92 eligible patients were 1:1 randomly assigned into training and validation cohorts. Pre-RT and mid-RT radiomic features were extracted from pre-treatment and interim CT. LASSO-Cox regression was used for feature selection and model construction. Time-dependent area under the receiver operating curve (AUC) analysis was applied to evaluate the models' prognostic performances. Risk stratification ability on overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method and Cox regression. The associations between radiomics and clinical parameters as well as circulating lymphocyte counts were also evaluated.

Results: The mid-RT peritumoral (AUC: 0.77) and intratumoral (AUC: 0.79) radiomic models yielded better performance for predicting OS than the pre-RT intratumoral model (AUC: 0.62) in validation cohort. This was confirmed by Kaplan-Meier analysis, in which risk stratification depended on the mid-RT peritumoral (p = 0.009) and intratumoral (p = 0.003) radiomics could be improved for OS, in comparison to the pre-RT intratumoral radiomics (p = 0.199). Multivariate analysis identified mid-RT peritumoral and intratumoral radiomic models as independent prognostic factors for both OS and PFS. Mid-RT peritumoral and intratumoral radiomics were correlated with treatment-related lymphopenia.

Conclusion: Mid-RT peritumoral and intratumoral radiomic models are promising image biomarkers that could have clinical utility for predicting OS and PFS in patients with LHC treated with RT.

Keywords: Biomarker; Laryngeal and hypopharyngeal cancer; Lymphocyte; Prognosis; Radiomics; Radiotherapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Humans
  • Hypopharyngeal Neoplasms* / diagnostic imaging
  • Hypopharyngeal Neoplasms* / radiotherapy
  • Laryngeal Neoplasms* / diagnostic imaging
  • Laryngeal Neoplasms* / radiotherapy
  • Prognosis
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods