Incorporating radiomic feature of pretreatment 18F-FDG PET improves survival stratification in patients with EGFR-mutated lung adenocarcinoma.
Adenocarcinoma of Lung
/ diagnosis
Aged
ErbB Receptors
/ antagonists & inhibitors
Feasibility Studies
Female
Fluorodeoxyglucose F18
/ administration & dosage
Follow-Up Studies
Humans
Image Interpretation, Computer-Assisted
Lung
/ diagnostic imaging
Lung Neoplasms
/ diagnosis
Male
Middle Aged
Models, Statistical
Mutation
Neoplasm Staging
Positron Emission Tomography Computed Tomography
Prognosis
Progression-Free Survival
Protein Kinase Inhibitors
/ therapeutic use
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
28
05
2020
accepted:
10
12
2020
entrez:
28
12
2020
pubmed:
29
12
2020
medline:
20
3
2021
Statut:
epublish
Résumé
To investigate the survival prognostic value of the radiomic features of 18F-FDG PET in patients who had EGFR (epidermal growth factor receptor) mutated lung adenocarcinoma and received targeted TKI (tyrosine kinase inhibitor) treatment. Fifty-one patients with stage III-IV lung adenocarcinoma and actionable EGFR mutation who received first-line TKI were retrospectively analyzed. All patients underwent pretreatment 18F-FDG PET/CT, and we calculated the PET-derived radiomic features. Cox proportional hazard model was used to examine the association between the radiomic features and the survival outcomes, including progression-free survival (PFS) and overall survival (OS). A score model was established according to the independent prognostic predictors and we compared this model to the TNM staging system using Harrell's concordance index (c-index). Forty-eight patients (94.1%) experienced disease progression and 41 patients (80.4%) died. Primary tumor SUV entropy > 5.36, and presence of pleural effusion were independently associated with worse OS (both p < 0.001) and PFS (p = 0.001, and 0.003, respectively). We used these two survival predictors to devise a scoring system (score 0-2). Patients with a score of 1 or 2 had a worse survival than those with a score of 0 (HR for OS: 3.6, p = 0.006 for score 1, and HR: 21.8, p < 0.001 for score 2; HR for PFS: 2.2, p = 0.027 for score 1 and HR: 8.8, p < 0.001 for score 2). Our scoring system surpassed the TNM staging system (c-index = 0.691 versus 0.574, p = 0.013 for OS, and c-index = 0.649 versus 0.517, p = 0.004 for PFS). In this preliminary study, combining PET radiomics with clinical risk factors may improve survival stratification in stage III-IV lung adenocarcinoma with actionable EFGR mutation. Our proposed scoring system may assist with optimization of individualized treatment strategies in these patients.
Sections du résumé
BACKGROUND
To investigate the survival prognostic value of the radiomic features of 18F-FDG PET in patients who had EGFR (epidermal growth factor receptor) mutated lung adenocarcinoma and received targeted TKI (tyrosine kinase inhibitor) treatment.
METHODS
Fifty-one patients with stage III-IV lung adenocarcinoma and actionable EGFR mutation who received first-line TKI were retrospectively analyzed. All patients underwent pretreatment 18F-FDG PET/CT, and we calculated the PET-derived radiomic features. Cox proportional hazard model was used to examine the association between the radiomic features and the survival outcomes, including progression-free survival (PFS) and overall survival (OS). A score model was established according to the independent prognostic predictors and we compared this model to the TNM staging system using Harrell's concordance index (c-index).
RESULTS
Forty-eight patients (94.1%) experienced disease progression and 41 patients (80.4%) died. Primary tumor SUV entropy > 5.36, and presence of pleural effusion were independently associated with worse OS (both p < 0.001) and PFS (p = 0.001, and 0.003, respectively). We used these two survival predictors to devise a scoring system (score 0-2). Patients with a score of 1 or 2 had a worse survival than those with a score of 0 (HR for OS: 3.6, p = 0.006 for score 1, and HR: 21.8, p < 0.001 for score 2; HR for PFS: 2.2, p = 0.027 for score 1 and HR: 8.8, p < 0.001 for score 2). Our scoring system surpassed the TNM staging system (c-index = 0.691 versus 0.574, p = 0.013 for OS, and c-index = 0.649 versus 0.517, p = 0.004 for PFS).
CONCLUSIONS
In this preliminary study, combining PET radiomics with clinical risk factors may improve survival stratification in stage III-IV lung adenocarcinoma with actionable EFGR mutation. Our proposed scoring system may assist with optimization of individualized treatment strategies in these patients.
Identifiants
pubmed: 33370365
doi: 10.1371/journal.pone.0244502
pii: PONE-D-20-14167
pmc: PMC7769431
doi:
Substances chimiques
Protein Kinase Inhibitors
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
EGFR protein, human
EC 2.7.10.1
ErbB Receptors
EC 2.7.10.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0244502Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Stat Med. 2015 Feb 20;34(4):685-703
pubmed: 25399736
Med Oncol. 2017 Sep 1;34(10):169
pubmed: 28864950
Eur J Nucl Med Mol Imaging. 2015 Mar;42(3):419-28
pubmed: 25339524
Eur J Cancer. 2016 Jul;62:132-7
pubmed: 27189322
Eur J Cancer. 2019 Nov;121:98-108
pubmed: 31569068
N Engl J Med. 2004 May 20;350(21):2129-39
pubmed: 15118073
PLoS One. 2013 May 01;8(5):e54659
pubmed: 23658677
Radiother Oncol. 2011 Nov;101(2):291-7
pubmed: 21889224
Ann Nucl Med. 2019 Sep;33(9):657-670
pubmed: 31218571
Ann Nucl Med. 2018 Nov;32(9):602-610
pubmed: 30014440
J Clin Oncol. 2014 Mar 20;32(9):960-7
pubmed: 24550423
Chang Gung Med J. 2005 May;28(5):296-305
pubmed: 16086544
Biomed Mater Eng. 2014;24(6):3091-103
pubmed: 25227018
Radiology. 2016 Feb;278(2):593-600
pubmed: 26323029
Chin J Cancer. 2016 Mar 21;35:30
pubmed: 27001083
Cell. 2017 Feb 9;168(4):613-628
pubmed: 28187284
Respir Med. 2010 Dec;104(12):1767-74
pubmed: 20833010
J Nucl Med. 2015 Jan;56(1):45-9
pubmed: 25525185
Mol Imaging Biol. 2016 Oct;18(5):788-95
pubmed: 26920355
BMC Med. 2017 Jul 18;15(1):133
pubmed: 28716075
Rev Esp Med Nucl Imagen Mol. 2017 Nov - Dec;36(6):342-349
pubmed: 28566260
Epidemiology. 2001 Mar;12(2):256-8
pubmed: 11246589
Asia Pac J Clin Oncol. 2017 Aug;13(4):304-313
pubmed: 28124437
Sci Transl Med. 2012 Mar 28;4(127):127ps10
pubmed: 22461637
Radiology. 2015 Sep;276(3):883-93
pubmed: 25897473
Eur J Nucl Med Mol Imaging. 2020 May;47(5):1137-1146
pubmed: 31728587
World J Radiol. 2014 Jul 28;6(7):392-8
pubmed: 25071879
Lung Cancer. 2014 Jul;85(1):19-24
pubmed: 24768581
J Thorac Oncol. 2018 Sep;13(9):1363-1372
pubmed: 29802888
N Engl J Med. 2018 Jan 11;378(2):113-125
pubmed: 29151359
CA Cancer J Clin. 2019 Jan;69(1):7-34
pubmed: 30620402
Acta Oncol. 2013 Oct;52(7):1391-7
pubmed: 24047337
Eur J Nucl Med Mol Imaging. 2019 Feb;46(2):446-454
pubmed: 30145701
Eur Respir J. 1997 Aug;10(8):1701-2
pubmed: 9272907
Onco Targets Ther. 2015 Dec 15;8:3749-56
pubmed: 26719702
PLoS One. 2020 Feb 25;15(2):e0228793
pubmed: 32097418
J Nucl Med. 2014 Mar;55(3):414-22
pubmed: 24549286
Arch Pathol Lab Med. 2013 Jun;137(6):828-60
pubmed: 23551194
Cancer Res. 2017 Nov 1;77(21):e104-e107
pubmed: 29092951
Front Oncol. 2013 Jan 03;2:208
pubmed: 23316478
J Thorac Cardiovasc Surg. 2010 Jun;139(6):1441-6
pubmed: 19939412
Lancet Oncol. 2019 May;20(5):625-635
pubmed: 30975627
Am Soc Clin Oncol Educ Book. 2014;:e353-65
pubmed: 24857124
J Clin Oncol. 2012 Feb 1;30(4):433-40
pubmed: 22215752
Cancers (Basel). 2019 Jul 01;11(7):
pubmed: 31266248
J Nucl Med. 2019 May;60(5):600-607
pubmed: 30389824
Mol Cancer. 2019 Nov 20;18(1):165
pubmed: 31747941
Lung Cancer. 2011 Mar;71(3):249-57
pubmed: 21216486
J Nucl Med. 2013 Oct;54(10):1703-9
pubmed: 24042030
J Radiat Res. 2017 Nov 1;58(6):862-869
pubmed: 29036692
Clin Cancer Res. 2004 Nov 1;10(21):7252-9
pubmed: 15534099
Eur J Nucl Med Mol Imaging. 2019 Dec;46(13):2638-2655
pubmed: 31240330
Ther Adv Respir Dis. 2016 Apr;10(2):113-29
pubmed: 26620497
Front Oncol. 2019 Oct 15;9:1062
pubmed: 31681597
Radiat Oncol. 2015 Apr 22;10:100
pubmed: 25900186
J Thorac Dis. 2016 Mar;8(3):E200-3
pubmed: 27076970
J Nucl Med. 2017 Mar;58(3):406-411
pubmed: 27765856
Cancer. 2018 Oct 1;124(19):3830-3838
pubmed: 30192383
Annu Int Conf IEEE Eng Med Biol Soc. 2016 Aug;2016:1268-1271
pubmed: 28268556
Ann Nucl Med. 2020 Jan;34(1):49-57
pubmed: 31659591
CA Cancer J Clin. 2015 Mar;65(2):87-108
pubmed: 25651787
Radiology. 2014 Jan;270(1):141-8
pubmed: 23985274