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Radiomic analysis to predict local response in locally advanced pancreatic cancer treated with stereotactic body radiation therapy

  • Radiotherapy
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Abstract

Purpose

Aim of this study is to assess the ability of contrast-enhanced CT image-based radiomic analysis to predict local response (LR) in a retrospective cohort of patients affected by pancreatic cancer and treated with stereotactic body radiation therapy (SBRT). Secondary aim is to evaluate progression free survival (PFS) and overall survival (OS) at long-term follow-up.

Methods

Contrast-enhanced-CT images of 37 patients who underwent SBRT were analyzed. Two clinical variables (BED, CTV volume), 27 radiomic features were included. LR was used as the outcome variable to build the predictive model. The Kaplan–Meier method was used to evaluate PFS and OS.

Results

Three variables were statistically correlated with the LR in the univariate analysis: Intensity Histogram (StdValue feature), Gray Level Cooccurrence Matrix (GLCM25_Correlation feature) and Neighbor Intensity Difference (NID25_Busyness feature). Multivariate model showed GLCM25_Correlation (P = 0.007) and NID25_Busyness (P = 0.03) as 2 independent predictive variables for LR. The odds ratio values of GLCM25_Correlation and NID25_Busyness were 0.07 (95%CI 0.01–0.49) and 8.10 (95%CI 1.20–54.40), respectively. The area under the curve for the multivariate logistic regressive model was 0.851 (95%CI 0.724–0.978). At a median follow-up of 30 months, median PFS was 7 months (95%CI 6-NA); median OS was 11 months (95%CI 10–22 months).

Conclusions

This analysis identified a radiomic signature that correlates with LR. To confirm these results, prospective studies could identify patient sub-groups with different rates of radiation dose–response to define a more personalized SBRT approach.

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Authors and Affiliations

  1. Radiation Oncology Department, General Regional Hospital “F. Miulli”, Strada Prov 127, 70021, Acquaviva delle Fonti-Bari, Italy

    Fabiana Gregucci, Alba Fiorentino, Ilaria Bonaparte, Alessia Surgo, Roberta Carbonara, Morena Caliandro & Maria Paola Ciliberti

  2. Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy

    Rosario Mazzola, Francesco Ricchetti, Vanessa Figlia, Ruggero Ruggieri & Filippo Alongi

  3. University of Brescia, Brescia, Italy

    Filippo Alongi

Authors
  1. Fabiana Gregucci
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  2. Alba Fiorentino
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Correspondence to Fabiana Gregucci.

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Gregucci, F., Fiorentino, A., Mazzola, R. et al. Radiomic analysis to predict local response in locally advanced pancreatic cancer treated with stereotactic body radiation therapy. Radiol med 127, 100–107 (2022). https://doi.org/10.1007/s11547-021-01422-z

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