Developing a clinical-radiomic prediction model for 3-year cancer-specific survival in lung cancer patients treated with stereotactic body radiation therapy

Purpose The study aims to develop and validate a combined model for predicting 3-year cancer-specific survival (CSS) in lung cancer patients treated with stereotactic body radiation therapy (SBRT) by integrating clinical and radiomic parameters. Methods Clinical data and pre-treatment CT images were collected from 102 patients treated with lung SBRT. Multivariate logistic regression and the least absolute shrinkage and selection operator were used to determine the clinical and radiomic factors associated with 3-year CSS. Three prediction models were developed using clinical factors, radiomic factors, and a combination of both. The performance of the models was assessed using receiver operating characteristic curve and calibration curve. A nomogram was also created to visualize the 3-year CSS prediction. Results With a 36-month follow-up, 40 patients (39.2%) died of lung cancer and 62 patients (60.8%) survived. Three clinical factors, including gender, clinical stage, and lymphocyte ratio, along with three radiomic features, were found to be independent factors correlated with 3-year CSS. The area under the curve values for the clinical, radiomic, and combined model were 0.839 (95% CI 0.735–0.914), 0.886 (95% CI 0.790–0.948), and 0.914 (95% CI 0.825–0.966) in the training cohort, and 0.757 (95% CI 0.580–0.887), 0.818 (95% CI 0.648–0.929), and 0.843 (95% CI 0.677–0.944) in the validation cohort, respectively. Additionally, the calibration curve demonstrated good calibration performance and the nomogram created from the combined model showed potential for clinical utility. Conclusion A clinical-radiomic model was developed to predict the 3-year CSS for lung cancer patients treated with SBRT.