It has been shown that patients with HPV-associated OPSCC demonstrate improved treatment response to chemoradiation and prognosis compared to patients with HPV independent OPSCC, whose tumors are much more often associated with alcohol and tobacco use 2. Based on data from 2015 to 2019, about 47,199 new HPV-associated cancers occurred in the United States each year, accounting for about 70% of cancers of the oropharynx 1.
There has been a significant increase in the incidence of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) over the past several decades 1. The proposed radiomic signature was prognostic of patient survival and informed benefit from chemotherapy for stage I and II HPV-associated OPSCC patients. In contrast, chemotherapy did not improve OS for low-pRiS patients, which indicates these patients did not derive additional benefit from chemotherapy and could be considered for treatment de-escalation. Seven features were selected to construct pRiS, which was found to be prognostic of overall survival (OS) on univariate analysis in D 2 (hazard ratio = 2.14, 95% confidence interval, 1.1–4.16, p = 0.02) and D 3 (HR = 2.74, 95% CI, 1.34–5.62, p = 0.006). Patients from D 2 and D 3 who received either radiotherapy alone or chemoradiation were used to validate pRiS as predictive of added benefit of chemotherapy. The prognostic performance of pRiS was evaluated on two test sets (D 2, n = 162 D 3, n = 269) using concordance index. We aim to develop and validate a prognostic and predictive radiomic image signature (pRiS) to inform survival and chemotherapy benefit using computed tomography (CT) scans from 491 stage I and II HPV-associated OPSCC, which were divided into three cohorts D 1–D 3. However, not all patients benefit from chemotherapy, especially patients with low-risk characteristics. Chemoradiation is a common therapeutic regimen for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC).
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