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Evaluation the benefits of additional radiotherapy for gastric cancer patients after D2 resection using CT based radiomics

  • Abdominal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objectives

The value of adding radiotherapy (RT) is still unclear for patients with gastric cancer (GC) after D2 lymphadenectomy. The purpose of this study is to predict and compare the overall survival (OS) and disease-free survival (DFS) of GC patients treated by chemotherapy and chemoradiation based on contrast-enhanced CT (CECT) radiomics.

Methods

A total of 154 patients treated by chemotherapy and chemoradiation in authors’ hospital were retrospectively reviewed and randomly divided into the training and testing cohorts (7:3). Radiomics features were extracted from contoured tumor volumes in CECT using the pyradiomics software. Radiomics score and nomogram with integrated clinical factors were developed to predict the OS and DFS and evaluated with Harrell's Consistency Index (C-index).

Results

Radiomics score achieved a C index of 0.721(95%CI: 0.681–0.761) and 0.774 (95%CI: 0.738–0.810) in the prediction of DFS and OS for GC patients treated by chemotherapy and chemoradiation, respectively. The benefits of additional RT only demonstrated in subgroup of GC patients with Lauren intestinal type and perineural invasion (PNI). Integrating clinical factors further improved the prediction ability of radiomics models with a C-index of 0.773 (95%CI: 0.736–0.810) and 0.802 (95%CI: 0.765–0.839) for DFS and OS, respectively.

Conclusions

CECT based radiomics is feasible to predict the OS and DFS for GC patients underwent chemotherapy and chemoradiation after D2 resection. The benefits of additional RT only observed in GC patients with intestinal cancer and PNI.

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Availability of data and materials

Research data are stored in an institutional repository. The datasets are available from the corresponding author on reasonable request.

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Funding

This work was supported by Major Project of Wenzhou Science and Technology Bureau (ZY2022016).

Author information

Author notes

  1. Haoze Zheng and Qiao Zheng have authors contribute equally to this work.

Authors and Affiliations

  1. Department of Radiotherapy Center, 1St Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Haoze Zheng, Qiao Zheng, Didi Chen, Ce Han, Jinling Yi, Yao Ai, Jingyi Yan & Xiance Jin

  2. Department of Radiology, 1St Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Mengmeng Jiang

  3. Department of Gastrointestinal Surgery, 1St Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

    Jingyi Yan

  4. School of Basic Medical Science, Wenzhou Medical University, Wenzhou, China

    Xiance Jin

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  1. Haoze Zheng
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Contributions

All authors contributed to the study conception and design. HZ and QZ performed and analyzed most of statistical experiments. MJ and JY designed, supervised the project. DC and XJ wrote the manuscript. JY, YA and CH verifiedthethe accuracy of the data analysis. All authors have read and approved the final manuscript.

Corresponding authors

Correspondence to Jingyi Yan or Xiance Jin.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the institutional Ethics Committee in Clinical Research (ECCR).

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Written informed consent was waived by the ECCR due to the retrospectively nature of this study (ECCR no. 2019059).

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Zheng, H., Zheng, Q., Jiang, M. et al. Evaluation the benefits of additional radiotherapy for gastric cancer patients after D2 resection using CT based radiomics. Radiol med 128, 679–688 (2023). https://doi.org/10.1007/s11547-023-01646-1

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  • DOI: https://doi.org/10.1007/s11547-023-01646-1

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