e15559 Background: To determine the association between tumor heterogeneity, morphologic tumor response, and overall survival in primary esophageal squamous cell cancer (ESCC) treated with chemotherapy and radiation therapy (CRT). Methods: After an institutional review board waiver was obtained, 57 clinical stage III patients with CRT were analysis. All patients underwent contrast-enhanced CT before RT and after RT 40Gy between 2012 and 2015 were analyzed in terms of whole-tumor texture, with quantification of entropy, uniformity, max and mean gray-level intensity, kurtosis, standard deviation of the histogram, mass and skewness for fine to coarse textures (filters 1.0-2.5, respectively). Whole-tumor texture was analyzed using IBEX 1.0β. The association between texture parameters and survival time was assessed by using Kaplan-Meier analysis and a Cox proportional hazards model. Results: The median, 1 and 3 years overall survival (OS)were 20.2 months 75.4% and 32.1% .Only the clinical factor posttreatment volume (median OS, 28.4 vs 14 months; P = 0.016), pretreatment median entropy of 0.069 or greater (median OS, 31.6 vs 17.0 months; P = 0.022), and medium max gray-level intensity of 11 or greater (median OS, 33.2 vs 11.7 months; P = 0.034),Coarse kurtosis of 58.4122 or greater (median OS, 28.4 vs 15.0months; P = 0.036) were associated with improved survival time. Survival models that included a combination of pretreatment entropy and posttreatment volume. We used a 3-point risk classification index with equal weights given to entropy and volume predict OS and progression-free survival (PFS). The median OS for high-, medium-, and low-risk groups were12.2, 19.1, and 31.7 months,respectively (P = 0.013). Validated the risk model in PFS, The median PFS for high-, medium-, and low-risk groups were 8.0, 18.5, and not received months,respectively (P = 0.043). Conclusions: Pretreatment texture parameters are associated with survival time, and the combination of pretreatment texture parameters and post volume performed better in survival models.
Advanced Hepatocellular Carcinoma: Pretreatment Contrast-enhanced CT Texture Parameters as Predictive Biomarkers of Survival in Patients Treated with Sorafenib