Analyzing oropharyngeal cancer survival outcomes: a decision tree approach

Br J Radiol. 2020 Jul;93(1111):20190464. doi: 10.1259/bjr.20190464. Epub 2020 May 21.

Abstract

Objectives: To analyze survival outcomes in patients with oropharygeal cancer treated with primary intensity modulated radiotherapy (IMRT) using decision tree algorithms.

Methods: A total of 273 patients with newly diagnosed oropharyngeal cancer were identified between March 2010 and December 2016. The data set contained nine predictor variables and a dependent variable (overall survival (OS) status). The open-source R software was used. Survival outcomes were estimated by Kaplan-Meier method. Important explanatory variables were selected using the random forest approach. A classification tree that optimally partitioned patients with different OS rates was then built.

Results: The 5 year OS for the entire population was 78.1%. The top three important variables identified were HPV status, N stage and early complete response to treatment. Patients were partitioned in five groups on the basis of these explanatory variables.

Conclusion: The proposed classification tree could help to guide future research in oropharyngeal cancer field.

Advances in knowledge: Decision tree method seems to be an appropriate tool to partition oropharyngeal cancer patients.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Decision Trees
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / diagnosis
  • Oropharyngeal Neoplasms / mortality*
  • Oropharyngeal Neoplasms / radiotherapy
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / mortality
  • Positron Emission Tomography Computed Tomography / methods
  • Radiopharmaceuticals
  • Radiotherapy, Intensity-Modulated / methods
  • Radiotherapy, Intensity-Modulated / mortality*
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck / diagnosis
  • Squamous Cell Carcinoma of Head and Neck / mortality*
  • Squamous Cell Carcinoma of Head and Neck / radiotherapy
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18