Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status

Dan Ou; Pierre Blanchard; Silvia Rosellini; Antonin Levy; France Nguyen; Ralph T. H. Leijenaar; Ingrid Garberis; Philippe Gorphe; Francois Bidault; Charles Ferte; Charlotte Robert; Odile Casiraghi; Jean-Yves Scoazec; Philippe Lambin; Stephane Temam; Eric Deutsch; Yungan Tao

doi:10.1016/j.oraloncology.2017.06.015

Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status

Dan Ou, Pierre Blanchard, Silvia Rosellini, Antonin Levy, France Nguyen, Ralph T. H. Leijenaar, Ingrid Garberis, Philippe Gorphe, Francois Bidault, Charles Ferte, Charlotte Robert, Odile Casiraghi, Jean-Yves Scoazec, Philippe Lambin, Stephane Temam, Eric Deutsch, Yungan Tao^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Objectives: To explore prognostic and predictive value of radiomics in patients with locally advanced head and neck squamous cell carcinomas (LAHNSCC) treated with concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT).

Materials and Methods: Data of 120 patients (CRT vs. BRT matched 2: 1) were retrospectively analyzed. A total of 544 radiomics features of the primary tumor were extracted from radiotherapy planning computed tomography scans. Cox proportional hazards models were used to examine the association between survival and radiomics features with false discovery rate correction. The discriminatory performance was evaluated using receiver operating characteristic curve analysis.

Results: Multivariate analysis showed a 24-feature based signature significantly predicted for OS (HR = 0.3, P = 0.02) and progression-free survival (PFS) (HR = 0.3, P = 0.01). Combining the radiomics signature with p16 status showed a significant improvement of prognostic performance compared with p16 (AUC = 0.78 vs. AUC = 0.64 at 5 years, P = 0.01) or radiomics signature (AUC = 0.78 vs. AUC = 0.67, P = 0.01) alone. When patients were stratified according to this combination, OS and PFS were significantly different according to the 4 sub-types (p16+ with low/high signature score; p16-with low/high signature score) (P <0.001). Patients with high signature score significantly benefited from CRT (vs. BRT) in terms of OS (P = 0.004), while no benefit from CRT in patients with low signature score.

Conclusion: Our analysis suggests an added value of radiomics features as prognostic and predictive biomarker in HNSCC treated with CRT/BRT. Moreover, the radiomics signature provided additional information to HPV/p16 status to further stratify patients. External validation of such findings is mandatory given the risk of overfitting. (C) 2017 Elsevier Ltd. All rights reserved.

Original language	English
Pages (from-to)	150-155
Number of pages	6
Journal	Oral Oncology
Volume	71
DOIs	https://doi.org/10.1016/j.oraloncology.2017.06.015
Publication status	Published - Aug 2017

Keywords

Radiomics
Locally advanced head and neck cancer
HPV
Chemoradiotherapy
Bioradiotherapy
SQUAMOUS-CELL CARCINOMAS
TEXTURE ANALYSIS
OROPHARYNGEAL CANCER
SURVIVAL
HETEROGENEITY
RADIOTHERAPY
CISPLATIN
BIOMARKER
CETUXIMAB
CHEMOTHERAPY

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Ou, D., Blanchard, P., Rosellini, S., Levy, A., Nguyen, F., Leijenaar, R. T. H., Garberis, I., Gorphe, P., Bidault, F., Ferte, C., Robert, C., Casiraghi, O., Scoazec, J-Y., Lambin, P., Temam, S., Deutsch, E., & Tao, Y. (2017). Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status. Oral Oncology, 71, 150-155. https://doi.org/10.1016/j.oraloncology.2017.06.015

@article{f0384112b3db42f2b0a823ab9353b47f,

title = "Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status",

abstract = "Objectives: To explore prognostic and predictive value of radiomics in patients with locally advanced head and neck squamous cell carcinomas (LAHNSCC) treated with concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT).Materials and Methods: Data of 120 patients (CRT vs. BRT matched 2: 1) were retrospectively analyzed. A total of 544 radiomics features of the primary tumor were extracted from radiotherapy planning computed tomography scans. Cox proportional hazards models were used to examine the association between survival and radiomics features with false discovery rate correction. The discriminatory performance was evaluated using receiver operating characteristic curve analysis.Results: Multivariate analysis showed a 24-feature based signature significantly predicted for OS (HR = 0.3, P = 0.02) and progression-free survival (PFS) (HR = 0.3, P = 0.01). Combining the radiomics signature with p16 status showed a significant improvement of prognostic performance compared with p16 (AUC = 0.78 vs. AUC = 0.64 at 5 years, P = 0.01) or radiomics signature (AUC = 0.78 vs. AUC = 0.67, P = 0.01) alone. When patients were stratified according to this combination, OS and PFS were significantly different according to the 4 sub-types (p16+ with low/high signature score; p16-with low/high signature score) (P <0.001). Patients with high signature score significantly benefited from CRT (vs. BRT) in terms of OS (P = 0.004), while no benefit from CRT in patients with low signature score.Conclusion: Our analysis suggests an added value of radiomics features as prognostic and predictive biomarker in HNSCC treated with CRT/BRT. Moreover, the radiomics signature provided additional information to HPV/p16 status to further stratify patients. External validation of such findings is mandatory given the risk of overfitting. (C) 2017 Elsevier Ltd. All rights reserved.",

keywords = "Radiomics, Locally advanced head and neck cancer, HPV, Chemoradiotherapy, Bioradiotherapy, SQUAMOUS-CELL CARCINOMAS, TEXTURE ANALYSIS, OROPHARYNGEAL CANCER, SURVIVAL, HETEROGENEITY, RADIOTHERAPY, CISPLATIN, BIOMARKER, CETUXIMAB, CHEMOTHERAPY",

author = "Dan Ou and Pierre Blanchard and Silvia Rosellini and Antonin Levy and France Nguyen and Leijenaar, {Ralph T. H.} and Ingrid Garberis and Philippe Gorphe and Francois Bidault and Charles Ferte and Charlotte Robert and Odile Casiraghi and Jean-Yves Scoazec and Philippe Lambin and Stephane Temam and Eric Deutsch and Yungan Tao",

year = "2017",

month = aug,

doi = "10.1016/j.oraloncology.2017.06.015",

language = "English",

volume = "71",

pages = "150--155",

journal = "Oral Oncology",

issn = "1368-8375",

publisher = "Elsevier Science",

}

Ou, D, Blanchard, P, Rosellini, S, Levy, A, Nguyen, F, Leijenaar, RTH, Garberis, I, Gorphe, P, Bidault, F, Ferte, C, Robert, C, Casiraghi, O, Scoazec, J-Y, Lambin, P, Temam, S, Deutsch, E & Tao, Y 2017, 'Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status', Oral Oncology, vol. 71, pp. 150-155. https://doi.org/10.1016/j.oraloncology.2017.06.015

Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status. / Ou, Dan; Blanchard, Pierre; Rosellini, Silvia et al.

In: Oral Oncology, Vol. 71, 08.2017, p. 150-155.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status

AU - Ou, Dan

AU - Blanchard, Pierre

AU - Rosellini, Silvia

AU - Levy, Antonin

AU - Nguyen, France

AU - Leijenaar, Ralph T. H.

AU - Garberis, Ingrid

AU - Gorphe, Philippe

AU - Bidault, Francois

AU - Ferte, Charles

AU - Robert, Charlotte

AU - Casiraghi, Odile

AU - Scoazec, Jean-Yves

AU - Lambin, Philippe

AU - Temam, Stephane

AU - Deutsch, Eric

AU - Tao, Yungan

PY - 2017/8

Y1 - 2017/8

N2 - Objectives: To explore prognostic and predictive value of radiomics in patients with locally advanced head and neck squamous cell carcinomas (LAHNSCC) treated with concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT).Materials and Methods: Data of 120 patients (CRT vs. BRT matched 2: 1) were retrospectively analyzed. A total of 544 radiomics features of the primary tumor were extracted from radiotherapy planning computed tomography scans. Cox proportional hazards models were used to examine the association between survival and radiomics features with false discovery rate correction. The discriminatory performance was evaluated using receiver operating characteristic curve analysis.Results: Multivariate analysis showed a 24-feature based signature significantly predicted for OS (HR = 0.3, P = 0.02) and progression-free survival (PFS) (HR = 0.3, P = 0.01). Combining the radiomics signature with p16 status showed a significant improvement of prognostic performance compared with p16 (AUC = 0.78 vs. AUC = 0.64 at 5 years, P = 0.01) or radiomics signature (AUC = 0.78 vs. AUC = 0.67, P = 0.01) alone. When patients were stratified according to this combination, OS and PFS were significantly different according to the 4 sub-types (p16+ with low/high signature score; p16-with low/high signature score) (P <0.001). Patients with high signature score significantly benefited from CRT (vs. BRT) in terms of OS (P = 0.004), while no benefit from CRT in patients with low signature score.Conclusion: Our analysis suggests an added value of radiomics features as prognostic and predictive biomarker in HNSCC treated with CRT/BRT. Moreover, the radiomics signature provided additional information to HPV/p16 status to further stratify patients. External validation of such findings is mandatory given the risk of overfitting. (C) 2017 Elsevier Ltd. All rights reserved.

AB - Objectives: To explore prognostic and predictive value of radiomics in patients with locally advanced head and neck squamous cell carcinomas (LAHNSCC) treated with concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT).Materials and Methods: Data of 120 patients (CRT vs. BRT matched 2: 1) were retrospectively analyzed. A total of 544 radiomics features of the primary tumor were extracted from radiotherapy planning computed tomography scans. Cox proportional hazards models were used to examine the association between survival and radiomics features with false discovery rate correction. The discriminatory performance was evaluated using receiver operating characteristic curve analysis.Results: Multivariate analysis showed a 24-feature based signature significantly predicted for OS (HR = 0.3, P = 0.02) and progression-free survival (PFS) (HR = 0.3, P = 0.01). Combining the radiomics signature with p16 status showed a significant improvement of prognostic performance compared with p16 (AUC = 0.78 vs. AUC = 0.64 at 5 years, P = 0.01) or radiomics signature (AUC = 0.78 vs. AUC = 0.67, P = 0.01) alone. When patients were stratified according to this combination, OS and PFS were significantly different according to the 4 sub-types (p16+ with low/high signature score; p16-with low/high signature score) (P <0.001). Patients with high signature score significantly benefited from CRT (vs. BRT) in terms of OS (P = 0.004), while no benefit from CRT in patients with low signature score.Conclusion: Our analysis suggests an added value of radiomics features as prognostic and predictive biomarker in HNSCC treated with CRT/BRT. Moreover, the radiomics signature provided additional information to HPV/p16 status to further stratify patients. External validation of such findings is mandatory given the risk of overfitting. (C) 2017 Elsevier Ltd. All rights reserved.

KW - Radiomics

KW - Locally advanced head and neck cancer

KW - HPV

KW - Chemoradiotherapy

KW - Bioradiotherapy

KW - SQUAMOUS-CELL CARCINOMAS

KW - TEXTURE ANALYSIS

KW - OROPHARYNGEAL CANCER

KW - SURVIVAL

KW - HETEROGENEITY

KW - RADIOTHERAPY

KW - CISPLATIN

KW - BIOMARKER

KW - CETUXIMAB

KW - CHEMOTHERAPY

U2 - 10.1016/j.oraloncology.2017.06.015

DO - 10.1016/j.oraloncology.2017.06.015

M3 - Article

VL - 71

SP - 150

EP - 155

JO - Oral Oncology

JF - Oral Oncology

SN - 1368-8375

ER -

Ou D, Blanchard P, Rosellini S, Levy A, Nguyen F, Leijenaar RTH et al. Predictive and prognostic value of CT based radiomics signature in locally advanced head and neck cancers patients treated with concurrent chemoradiotherapy or bioradiotherapy and its added value to Human Papillomavirus status. Oral Oncology. 2017 Aug;71:150-155. doi: 10.1016/j.oraloncology.2017.06.015