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Tytuł:
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Detailed Analysis and Radiomic Prediction of First Progression Sites of First-Line Targeted Therapy for EGFR-Mutant Lung Adenocarcinoma Patients With Systemic Metastasis.
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Autorzy:
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Li X; Department of Radiation Oncology, The First Affiliated Hospital of The University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.; Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Hou R; Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.; School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Yu W; Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Zhu X; Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Li H; Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College and Tumor Hospital Affiliated to Bengbu Medical College, Bengbu, China.
Yang Y; Department of Engineering and Applied Physics of University of Science and Technology of China, Hefei, China.
Qian D; Department of Radiation Oncology, The First Affiliated Hospital of The University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Fu X; Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
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Źródło:
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Frontiers in oncology [Front Oncol] 2021 Oct 05; Vol. 11, pp. 757892. Date of Electronic Publication: 2021 Oct 05 (Print Publication: 2021).
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: [Lausanne : Frontiers Research Foundation]
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References:
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Contributed Indexing:
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Keywords: first-line TKI; progression sites; radiomics; radiotherapy; stage IV lung adenocarcinoma; systemic metastasis
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Entry Date(s):
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Date Created: 20211022 Latest Revision: 20220427
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Update Code:
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20240105
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PubMed Central ID:
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PMC8524083
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DOI:
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10.3389/fonc.2021.757892
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PMID:
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34676174
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Background: We aimed to analyze the first progression sites of first-line tyrosine kinase inhibitor (TKI) treatment for EGFR-mutant lung adenocarcinoma patients with systemic metastasis to recognize the potential candidates who might benefit from radiotherapy and establish a radiomic-based model to predict the first progression sites.
Materials and Methods: We retrospectively collected the clinical information and pre-treatment chest CT images of patients in Shanghai Chest Hospital from 2013 to 2017. All patients were diagnosed with stage IV EGFR-mutant lung adenocarcinoma and received TKI as first-line treatment. The first progression sites and survival were analyzed. The pre-treatment chest non-contrast CT images were utilized to establish a radiomic-based model to predict the first progression sites.
Results: We totally collected 233 patients with systemic metastasis, among whom, there were 84 (36.1%) and 149 (63.9%) patients developing first progression in original lesions (OP) and new lesions (NP), respectively. The PFS and OS of patients with OP were longer than those with NP (PFS 11 months vs . 8 months, p = 0.03, OS 50 months vs . 35 months, p = 0.046). For 67.9% of the patients with OF, disease progressed within five sites (oligoprogression). The radiomic-based model could predict the progression sites with an AUC value of 0.736, a specificity of 0.60, and a sensitivity of 0.750 in the independent validation set.
Conclusion: Among patients with systemic metastasis, there were 36.1% of patients developing OP at first progression who had a better prognosis than those developing NP. Patients with OP may be potential candidates who might benefit from radiotherapy. Radiomics is a useful method to distinguish patients developing OP and could provide some indications for radiotherapy.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2021 Li, Hou, Yu, Zhu, Li, Yang, Qian and Fu.)
