CT-based intratumoral and peritumoral radiomics to predict the treatment response to hepatic arterial infusion chemotherapy plus lenvatinib and PD-1 in high-risk hepatocellular carcinoma cases: a multi-center study.
Authors
Affiliations (6)
Affiliations (6)
- Department of Interventional Therapy II, Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Shandong First Medical University, Jinan, 250117, Shandong, China.
- Department of Oncology, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong, China.
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China.
- School of Medicine, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Jinan University, Guangzhou, 518037, China.
- Department of Radiology, Caoxian County Hospital, Heze, 274499, Shandong, China.
- Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, China. [email protected].
Abstract
Noninvasive and precise tools for treatment response estimation in patients with high-risk hepatocellular carcinoma (HCC) who could benefit from hepatic arterial infusion chemotherapy (HAIC) plus lenvatinib and humanized programmed death receptor-1 inhibitors (PD-1) (HAIC-LEN-PD1) are lacking. This study aimed to evaluate the predictive potential of intratumoral and peritumoral radiomics for preoperative treatment response assessment to HAIC-LEN-PD1 in high-risk HCC cases. Totally 630 high-risk HCC cases administered HAIC-LEN-PD1 at three institutions were retrospectively identified and assigned to training, validation and external test sets. Totally 1834 radiomic features were, respectively, obtained from intratumoral and peritumoral regions and radiomics models were established using five classifiers. Based on the optimal model, a nomogram was developed and evaluated using areas under the curves (AUCs), calibration curves and decision curve analysis (DCA). Overall survival (OS) and progression-free survival (PFS) were assessed by Kaplan-Meier curves. The Intratumoral + Peritumoral 10 mm (Intra + Peri10) radiomics models were superior to the intratumor models and peritumor models, with AUCs of 0.919 (95%CI 0.889-0.949) in the training set, 0.874 (95%CI 0.812-0.936) in validation set and 0.893 (95%CI 0.839-0.948) in external test sets. The nomogram had good calibration ability and clinical value, with the AUCs of 0.936 (95%CI 0.907-0.965) in the training set, 0.878 (95%CI 0.916-0.940) in validation set and 0.902 (95%CI 0.848-0.957) in external test sets. The Kaplan-Meier analysis showed that high-score patients had significantly shorter OS and PFS than the low-score patients (median OS: 11.7 vs. 29.6 months, the whole set, p < 0.001; median PFS: 6.0 vs. 12.0 months, the whole set, p < 0.001). The Intra + Peri10 model can effectively predict the treatment response of high-risk HCC cases administered HAIC-LEN-PD1. The nomogram could provide an effective tool to evaluate the treatment response and risk stratification.