Academic radiology · 2026
Outcomes of RALOX-HAIC-based Combination Therapy for Unresectable Hepatocellular Carcinoma with Radiomics-Powered Prediction.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Zhu Peilin, Lin Zhanzhou, Liang Zixi, Chen Yongru, Hu Chengguang, Deng Qiong, Su Kaiyan, Li Wenli, Li Qi, Hu Xiaoyun, Zang Mengya, Du Yangfeng, Chen Jinzhang, Song Yangda, Yuan Guosheng
Аннотация
RATIONALE AND OBJECTIVES: Unresectable hepatocellular carcinoma (uHCC) remains a formidable clinical challenge owing to the scarcity of effective treatment options and unsatisfactory therapeutic responses. The current study explored a combined regimen of RALOX-HAIC, lenvatinib, and camrelizumab in patients with uHCC. In addition, a radiomics-based nomogram was created to predict treatment outcomes and support individualized decision-making.
METHODS: A total of 98 patients with uHCC received RALOX-HAIC, along with lenvatinib and camrelizumab. Before initiating therapy, radiomics features were derived from pretreatment computed tomography (CT) images and subsequently integrated with clinical variables, such as HBV status and Child-Pugh score. A radiomics nomogram was generated and assessed based on the area under the receiver operating characteristic curve (AUC), calibration analysis, and decision curve analysis (DCA).
RESULTS: Triple therapy yielded an objective response rate (ORR) of 52.0%, disease control rate (DCR) of 90.8%, and median progression-free survival (PFS) of 10.7 months (95% CI: 7.3-20.5). The radiomics-guided nomogram showed high accuracy in the training (AUC: 0.986) and validation (AUC: 0.873) sets. The calibration curves showed close agreement between the projected and observed outcomes, and DCA confirmed the notable clinical merit. The main grade ≥3 toxicities included neutropenia and thrombocytopenia (68.4%), consistent with the profiles observed in comparable therapies.
CONCLUSION: The integrated approach exhibited promising antitumor activity and an acceptable safety profile. Moreover, the radiomics nomogram is a valuable tool for refining patient selection and advancing personalized treatment strategies for individuals with uHCC.
METHODS: A total of 98 patients with uHCC received RALOX-HAIC, along with lenvatinib and camrelizumab. Before initiating therapy, radiomics features were derived from pretreatment computed tomography (CT) images and subsequently integrated with clinical variables, such as HBV status and Child-Pugh score. A radiomics nomogram was generated and assessed based on the area under the receiver operating characteristic curve (AUC), calibration analysis, and decision curve analysis (DCA).
RESULTS: Triple therapy yielded an objective response rate (ORR) of 52.0%, disease control rate (DCR) of 90.8%, and median progression-free survival (PFS) of 10.7 months (95% CI: 7.3-20.5). The radiomics-guided nomogram showed high accuracy in the training (AUC: 0.986) and validation (AUC: 0.873) sets. The calibration curves showed close agreement between the projected and observed outcomes, and DCA confirmed the notable clinical merit. The main grade ≥3 toxicities included neutropenia and thrombocytopenia (68.4%), consistent with the profiles observed in comparable therapies.
CONCLUSION: The integrated approach exhibited promising antitumor activity and an acceptable safety profile. Moreover, the radiomics nomogram is a valuable tool for refining patient selection and advancing personalized treatment strategies for individuals with uHCC.