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Development of a prediction model for chemotherapy and immunotherapy response in esophageal squamous cell carcinoma patients using machine learning algorithms
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Jincheng CHEN1, Xiaoqin ZHANG2, Jie LIU1, Tongxin LI2, Yi WU2, Ping HE3, Wei WU1
Journal of Army Medical University | 2025, 47(6) : 591 - 601
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Journal of Army Medical University | 2025, 47(6): 591-601
• Clinical Medicine •
Development of a prediction model for chemotherapy and immunotherapy response in esophageal squamous cell carcinoma patients using machine learning algorithms
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Jincheng CHEN1, Xiaoqin ZHANG2, Jie LIU1, Tongxin LI2, Yi WU2, Ping HE3, Wei WU1
Affiliations
  • 1Department of Thoracic Surgery,First Affiliated Hospital,Army Medical University (Third Military Medical University);,
  • 2Department of Digital Medicine,College of Biomedical Engineering and Medical Imaging,Army Medical University (Third Military Medical University),Chongqing, China
  • 3Department of Cardiac Surgery,First Affiliated Hospital,Army Medical University (Third Military Medical University),Chongqing
Published: 2025-03-30 doi: 10.16016/j.2097-0927.202412113
Outline
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Objective‍

To develop models for predicting response to chemotherapy combined with immunotherapy in patients with esophageal squamous carcinoma with various machine learning algorithms, and then select the optimal model.

Methods‍

A retrospective study was performed for 174 patients with esophageal squamous cell carcinoma undergoing chemotherapy combined with immunotherapy admitted in Department of Thoracic Surgery of the First Affiliated Hospital of Army Medical University from January 2022 to December 2023. The CT scans and clinical information were collected before treatment. They were randomly divided into a training set (n=122) and a testing set (n=52) in a ratio of 7∶3. CT radiomic features were extracted and selected, and then 5 machine-learning algorithms were employed to establish the prediction models, including radiomics model and clinical-radiomics model. Five-fold cross-validation was conducted on the training set, and the performance of the prediction models was evaluated on the testing set using receiver operating characteristic (ROC) curve and the F1 score. The best-performing model was further explained using local interpretable model-agnostic explanations (LIME) algorithm.

Results‍

Among the 174 patients, 115 (66.1%) achieved clinical remission. From the clinical information and CT images, 1 clinical features and 10 radiomic features were identified. The area under of ROC curve (AUC) for the radiomics and clinical-radiomics models was 0.750 (95%CI: 0.616~0.883), and 0.766 (95%CI: 0.637~0.895), respectively. The F1 score of the optimal clinical-radiomics model was 0.829. LIME algorithm indicated that this best model demonstrated reliability in predicting individual samples.

Conclusion‍

The clinical-radiomics prediction model based on machine learning algorithm performs well, and can provide a reference for doctors' clinical decision-making by predicting the response to chemotherapy combined with immunotherapy in patients with esophageal squamous cell carcinoma.

esophageal neoplasms  /  machine learning  /  radiomics
陈金城, 张小勤, 刘杰, 李童心, 吴毅, 何萍, 吴蔚. 基于机器学习算法构建胸段食管鳞癌患者化疗联合免疫治疗反应预测模型的研究. 陆军军医大学学报, 2025 , 47 (6) : 591 -601 . DOI: 10.16016/j.2097-0927.202412113
Jincheng CHEN, Xiaoqin ZHANG, Jie LIU, Tongxin LI, Yi WU, Ping HE, Wei WU. Development of a prediction model for chemotherapy and immunotherapy response in esophageal squamous cell carcinoma patients using machine learning algorithms[J]. Journal of Army Medical University, 2025 , 47 (6) : 591 -601 . DOI: 10.16016/j.2097-0927.202412113
Year 2025 volume 47 Issue 6
17
6
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Article Info
doi: 10.16016/j.2097-0927.202412113
  • Receive Date:2024-12-24
  • Online Date:2026-10-30
  • Published:2025-03-30
Article Data
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History
  • Received:2024-12-24
  • Revised:2025-01-19
Affiliations
    1Department of Thoracic Surgery,First Affiliated Hospital,Army Medical University (Third Military Medical University);,
    2Department of Digital Medicine,College of Biomedical Engineering and Medical Imaging,Army Medical University (Third Military Medical University),Chongqing, China
    3Department of Cardiac Surgery,First Affiliated Hospital,Army Medical University (Third Military Medical University),Chongqing
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表12种不同金属材料的力学参数
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Number of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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