KEY TAKEAWAYS
- The study aimed to investigate the efficacy of PORT in identifying patients with NSCLC who benefit from the treatment.
- Researchers noticed significant advancements in predicting OS and PORT benefits in patients with NSCLC.
The value of postoperative radiotherapy (PORT) for patients with non-small cell lung cancer (NSCLC) remains controversial. A subset of patients may benefit from PORT. We aimed to identify patients with NSCLC who could benefit from PORT.
Zeliang Ma and the team aimed to conduct a comprehensive analysis to evaluate the efficacy of PORT in patients diagnosed with NSCLC.
They performed an inclusive analysis encompassing patients from cohorts 1 and 2 diagnosed with pathological Tany N2 M0 NSCLC, as well as patients with non-metastatic NSCLC from cohorts 3 to 6. The radiomic prognostic index (RPI) was developed utilizing radiomic texture features extracted from the primary lung nodule in preoperative chest CT scans in cohort 1, subsequently validated in other cohorts. A least absolute shrinkage and selection operator-Cox regularization model was employed for data dimension reduction, feature selection, and RPI construction.
Subsequently, a lymph-radiomic prognostic index (LRPI) was formulated by integrating RPI with positive lymph node number (PLN). Comparative analysis of patient outcomes between those who received PORT and those who did not was conducted within LRPI-defined subgroups.
About 228, 1003, 144, 422, 19, and 21 patients were eligible in cohorts 1-6. RPI predicted overall survival (OS) in all six cohorts: cohort 1 (HR = 2.31, 95% CI: 1.18-4.52), cohort 2 (HR = 1.64, 95% CI: 1.26-2.14), cohort 3 (HR = 2.53, 95% CI: 1.45-4.3), cohort 4 (HR = 1.24, 95% CI: 1.01-1.52), cohort 5 (HR = 2.56, 95% CI: 0.73-9.02), cohort 6 (HR = 2.30, 95% CI: 0.53-10.03).
LRPI predicted OS (C-index: 0.68, 95% CI: 0.60-0.75) better than the pT stage (C-index: 0.57, 95% CI: 0.50-0.63), pT + PLN (C-index: 0.58, 95% CI: 0.46-0.70), and RPI (C-index: 0.65, 95% CI: 0.54-0.75). The LRPI was used to categorize individuals into three risk groups; patients in the moderate-risk group benefited from PORT (HR = 0.60, 95% CI: 0.40-0.91; P = 0.02), while patients in the low-risk and high-risk groups did not.
The study concluded that preoperative CT-based radiomic and lymph-radiomic prognostic indexes offer promising tools for predicting OS and assessing the benefits of PORT in patients diagnosed with NSCLC.
This study is sponsored by the National key research and development program, Capital’s Funds for Health Improvement and Research, Beijing Xisike Clinical Oncology Research Foundation, and Beijing Hope Run Special Fund of Cancer Foundation of China.
Source: https://pubmed.ncbi.nlm.nih.gov/38741207/
Ma Z, Men Y, Liu Y, et al. (2024). “Preoperative CT-based radiomic prognostic index to predict the benefit of postoperative radiotherapy in patients with non-small cell lung cancer: a multicenter study.” Cancer Imaging. 2024 May 13;24(1):61. doi: 10.1186/s40644-024-00707-6. PMID: 38741207; PMCID: PMC11089675.
