Predicting The Efficacy Of Induction Chemotherapy For Locally Advanced Nasopharyngeal Carcinoma Based On MRI Radiomics Of Cervical Lymph Nodes

PurposeWe sought to investigate the sensitivity of patients with locally advanced nasopharyngeal carcinoma(LANPC)to induction chemotherapy based on magnetic resonance imaging(MRI)radiomics of the cervical lymph nodes,as well as to construct a prediction model for the efficacy of induction chemotherapy to guide the individualized treatment of LANPC.MethodsIn this retrospective study,72 patients with LANPC(staged TxN2+M0,T3+N1M0 according to AJCC 2018)were collected from June 2018 to December 2020.All eligible patients were from a prospective phase Ⅲ clinical study(LC2016PY015).All enrolled patients received two cycles of platinum combined with paclitaxel induction chemotherapy,and the head and neck plain and enhanced MRI was performed within 2 weeks before induction chemotherapy and 1 month after treatment.Two senior radiologists read MR images of patients’ head and neck under a double-blind condition,identified and delineated 387 cervical positive lymph nodes,and extracted the radiomics information of positive lymph nodes using open-source software 3Dslicer.After normalizing the radiomics data,t-test was used to preliminarily screen out some MRI radiomics features,and then logistic stepwise regression was used to screen out significant features combined with clinical features and hemato-immunology indexes.Finally,the model for predicting the efficacy of induction chemotherapy in patients with locally advanced nasopharyngeal carcinoma was constructed and presented in the form of a nomogram.Research resultBased on t-test and logistic stepwise regression statistical method,two typical radiomics features and two hemato-immunologic characteristics were selected from MR radiomics parameters,clinical characteristics and hemato-immunologic indexes.Science the significant features were included in the prediction model,the nomogram model was constructed to predict the efficacy of induction chemotherapy for locally advanced nasopharyngeal carcinoma.The receiver operating characteristic curve(ROC)of the training set and the test set were both above the diagonal,and the area under the ROC curve(AUC)were 0.886 and 0.917 respectively,indicating that the discrimination of the model was good.In conclusionCombining pre-treatment MRI radiomics and blood immunological indicators can predict whether patients with locally advanced nasopharyngeal carcinoma are sensitive to induction chemotherapy before the start of induction chemotherapy,and guide the insensitive patients to choose radical concurrent chemoradiation or other treatment methods to avoid delay in the treatment.