ABSTRACT
OBJECTIVES: To develop and validate a radiomics model for evaluating treatment response to immune-checkpoint inhibitor plus chemotherapy (ICI + CT) in patients with advanced esophageal squamous cell carcinoma (ESCC). METHODS: A total of 64 patients with advance ESCC receiving first-line ICI + CT at two centers between January 2019 and June 2020 were enrolled in this study. Both 2D ROIs and 3D ROIs were segmented. ComBat correction was applied to minimize the potential bias on the results due to different scan protocols. A total of 788 features were extracted and radiomics models were built on corrected/uncorrected 2D and 3D features by using 5-fold cross-validation. The performance of the radiomics models was assessed by its discrimination, calibration and clinical usefulness with independent validation. RESULTS: Five features and support vector machine algorithm were selected to build the 2D uncorrected, 2D corrected, 3D uncorrected and 3D corrected radiomics models. The 2D radiomics models significantly outperformed the 3D radiomics models in both primary and validation cohorts. When ComBat correction was used, the performance of 2D models was better (p = 0.0059) in the training cohort, and significantly better (p < 0.0001) in the validation cohort. The 2D corrected radiomics model yielded the optimal performance and was used to build the nomogram. The calibration curve of the radiomics model demonstrated good agreement between prediction and observation and the decision curve analysis confirmed the clinical utility. CONCLUSIONS: The easy-to-use 2D corrected radiomics model could facilitate noninvasive preselection of ESCC patients who would benefit from ICI + CT.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Esophageal Neoplasms/diagnostic imaging , Esophageal Squamous Cell Carcinoma/diagnostic imaging , Immune Checkpoint Inhibitors/therapeutic use , Support Vector Machine , Antibodies, Monoclonal, Humanized/administration & dosage , Bias , Biomarkers, Tumor , Carboplatin/administration & dosage , Combined Modality Therapy/methods , Docetaxel/administration & dosage , Esophageal Neoplasms/drug therapy , Esophageal Neoplasms/pathology , Esophageal Squamous Cell Carcinoma/drug therapy , Esophageal Squamous Cell Carcinoma/pathology , Female , Humans , Male , Middle Aged , Nomograms , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
ObjectiveReconstruction of oral and maxillofacial defects following resection of oral and maxillofacial malignant tumors is required to restore the patient's appearance and oral function. The aim of this study was to evaluate the application and value ofsoleus perforator flap from the lateral leg in repair of oral and maxillofacial defects.MethodsIn this retrospective study, ten patients with oral and maxil-lofacial malignancies who were admitted to the Department of Oral and Maxillofacial Surgery in Fuyang People's Hospital during the period from May 2015 to March 2019 were enrolled. The effect of soleus perforator flap from the lateral leg was ana-lyzed.At 1 month and 3 months after surgery, the recovery of oral function and donor sites, quality of life and surgical satisfaction were followed.ResultsAllpatients underwent operation successfully without skin flap necrosis or serious complications.At 3 months after surgery,voice function and swallowing func-tion were level 3. The scar hyperplasia was 1 case,donor itching1 case and paresthesia or dysfunction 0 case.Compared with those at 1 month after surgery, the scores at 3 months after surgery were increased using the University of Washington Quality of Life (UW-QOL) questionnaire(P<0.05). At 1 month and 3 months after sur-gery,patient satisfaction rateswere 80.00% and 90.00%, respectively.ConclusionThe soleus perforator flap from the lateral leg isideal for repairing oral and maxillofacial defects. The postoperative recovery of oral functio-nand donor sites is goodwith high quality of life and surgical satisfaction.
