{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:42:22Z","timestamp":1773466942853,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korea University Ansan Hospital","award":["K-2010971"],"award-info":[{"award-number":["K-2010971"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: To optimally predict lymph node (LN) failure after definite radiotherapy (RT) in head and neck cancer (HNC) with LN metastases, this study examined radiomics models extracted from CT images of different periods during RT. Materials and Methods: This study retrospectively collected radiologic and clinical information from patients undergoing definite RT over 60 Gy for HNC with LN metastases from January 2010 to August 2021. The same largest LNs in each patient from the initial simulation CT (CTpre) and the following simulation CT (CTmid) at approximately 40 Gy were indicated as regions of interest. LN failure was defined as residual or recurrent LN within 3 years after the end of RT. After the radiomics features were extracted, the radiomics alone model and the radiomics plus clinical parameters model from the set of CTpre and CTmid were compared. The LASSO method was applied to select features associated with LN failure. Results: Among 66 patients, 17 LN failures were observed. In the radiomics alone model, CTpre and CTmid had similar mean accuracies (0.681 and 0.697, respectively) and mean areas under the curve (AUC) (0.521 and 0.568, respectively). Radiomics features of spherical disproportion, size zone variance, and log minimum 2 were selected for CTpre plus clinical parameters. Volume, energy, homogeneity, and log minimum 1 were selected for CTmid plus clinical parameters. Clinical parameters including smoking, T-stage, ECE, and regression rate of LN were important for both CTpre and CTmid. In the radiomics plus clinical parameters models, the mean accuracy and mean AUC of CTmid (0.790 and 0.662, respectively) were more improved than those of CTpre (0.731 and 0.582, respectively). Conclusions: Both models using CTpre and CTmid were improved by adding clinical parameters. The radiomics model using CTmid plus clinical parameters was the best in predicting LN failure in our preliminary analyses.<\/jats:p>","DOI":"10.3390\/medicina60010092","type":"journal-article","created":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T05:50:38Z","timestamp":1704261038000},"page":"92","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Potential Radiomics\u2013Clinical Model for Predicting Failure of Lymph Node Control after Definite Radiotherapy in Locally Advanced Head and Neck Cancer"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8618-7261","authenticated-orcid":false,"given":"Seunghak","family":"Lee","sequence":"first","affiliation":[{"name":"Core Research and Development Center, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9371-9529","authenticated-orcid":false,"given":"Sunmin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, College of Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7431-4588","authenticated-orcid":false,"given":"Chai Hong","family":"Rim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, College of Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7739-4173","authenticated-orcid":false,"given":"Young Hen","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soon Young","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Ho","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won Sup","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, College of Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1016\/S1470-2045(16)30410-7","article-title":"Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: A phase 3, multicentre, randomised controlled trial","volume":"17","author":"Sun","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.oraloncology.2018.08.001","article-title":"Patterns of failure in high-metastatic node number human papillomavirus-positive oropharyngeal carcinoma","volume":"85","author":"Lee","year":"2018","journal-title":"Oral. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"625","DOI":"10.3109\/0284186X.2015.1117136","article-title":"Failure pattern and salvage treatment after radical treatment of head and neck cancer","volume":"55","author":"Pagh","year":"2016","journal-title":"Acta Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.1002\/hed.27075","article-title":"Recurrence pattern with respect to two different dose fractionations in patients with locally advanced head and neck cancer treated with chemoradiation using image-guided volumetric arc therapy","volume":"44","author":"Deshmukh","year":"2022","journal-title":"Head Neck"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2967\/jnmt.120.249540","article-title":"PET\/CT in the Evaluation of Hypoxia for Radiotherapy Planning in Head and Neck Tumors: Systematic Literature Review","volume":"49","author":"Lopes","year":"2021","journal-title":"J. Nucl. Med. Technol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3857\/roj.2020.01018","article-title":"A randomized prospective study comparing acute toxicity, compliance and objective response rate between simultaneous integrated boost and sequential intensity-modulated radiotherapy for locally advanced head and neck cancer","volume":"39","author":"Grover","year":"2021","journal-title":"Radiat. Oncol. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1016\/j.ijrobp.2007.04.088","article-title":"Meta-Analyses of Chemotherapy in Head and Neck Cancer (MACH-NC): An update","volume":"69","author":"Pignon","year":"2007","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1200\/JCO.2012.43.6097","article-title":"Long-term results of RTOG 91-11: A comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer","volume":"31","author":"Forastiere","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1007\/s00066-019-01483-0","article-title":"Predicting survival and local control after radiochemotherapy in locally advanced head and neck cancer by means of computed tomography based radiomics","volume":"195","author":"Cozzi","year":"2019","journal-title":"Strahlenther. Onkol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.oraloncology.2019.06.020","article-title":"The prognostic value of CT-based image-biomarkers for head and neck cancer patients treated with definitive (chemo-)radiation","volume":"95","author":"Zhai","year":"2019","journal-title":"Oral. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100806","DOI":"10.1016\/j.drup.2022.100806","article-title":"Microenvironment-driven intratumoral heterogeneity in head and neck cancers: Clinical challenges and opportunities for precision medicine","volume":"60","author":"Zaryouh","year":"2022","journal-title":"Drug Resist. Updat."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105083","DOI":"10.1016\/j.oraloncology.2020.105083","article-title":"External validation of nodal failure prediction models including radiomics in head and neck cancer","volume":"112","author":"Zhai","year":"2021","journal-title":"Oral. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1080\/0284186X.2021.1924401","article-title":"Prognostic role of pre-treatment magnetic resonance imaging (MRI)-based radiomic analysis in effectively cured head and neck squamous cell carcinoma (HNSCC) patients","volume":"60","author":"Alfieri","year":"2021","journal-title":"Acta Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"16755","DOI":"10.1038\/s41598-022-21159-7","article-title":"Integrated radiogenomics analyses allow for subtype classification and improved outcome prognosis of patients with locally advanced HNSCC","volume":"12","author":"Zwanenburg","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"819047","DOI":"10.3389\/fonc.2021.819047","article-title":"A Combined Model to Improve the Prediction of Local Control for Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy Based on Radiomic Signature Plus Clinical and Dosimetric Parameters","volume":"11","author":"Luo","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"104877","DOI":"10.1016\/j.oraloncology.2020.104877","article-title":"Radiomic analysis identifies tumor subtypes associated with distinct molecular and microenvironmental factors in head and neck squamous cell carcinoma","volume":"110","author":"Katsoulakis","year":"2020","journal-title":"Oral. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1002\/mp.13977","article-title":"Application of radiomics for the prediction of HPV status for patients with head and neck cancers","volume":"47","author":"Lu","year":"2020","journal-title":"Med. Phys."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3767","DOI":"10.1002\/mp.14926","article-title":"Intrinsic radiomic expression patterns after 20 Gy demonstrate early metabolic response of oropharyngeal cancers","volume":"48","author":"Lafata","year":"2021","journal-title":"Med. Phys."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Carles, M., Fechter, T., Grosu, A.L., Sorensen, A., Thomann, B., Stoian, R.G., Wiedenmann, N., R\u00fchle, A., Zamboglou, C., and Ruf, J. (2021). 18F-FMISO-PET Hypoxia Monitoring for Head-and-Neck Cancer Patients: Radiomics Analyses Predict the Outcome of Chemo-Radiotherapy. Cancers, 13.","DOI":"10.3390\/cancers13143449"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.phro.2022.10.004","article-title":"Predicting radiotherapy-induced xerostomia in head and neck cancer patients using day-to-day kinetics of radiomics features","volume":"24","author":"Berger","year":"2022","journal-title":"Phys. Imaging Radiat. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"824509","DOI":"10.3389\/fonc.2022.824509","article-title":"Prediction of Response to Induction Chemotherapy Plus Concurrent Chemoradiotherapy for Nasopharyngeal Carcinoma Based on MRI Radiomics and Delta Radiomics: A Two-Center Retrospective Study","volume":"12","author":"Xi","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/0284186X.2021.1983207","article-title":"Predicting response to radiotherapy of head and neck squamous cell carcinoma using radiomics from cone-beam CT images","volume":"61","author":"Sellami","year":"2022","journal-title":"Acta Oncol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/92\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:38:47Z","timestamp":1760103527000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/92"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,3]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["medicina60010092"],"URL":"https:\/\/doi.org\/10.3390\/medicina60010092","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,3]]}}}