Radiomics-driven multimodal integration in precision radiotherapy for nasopharyngeal carcinoma— current evidence, clinical barriers, and future directions
Abstract
Nasopharyngeal carcinoma (NPC), a head and neck malignancy, is highly sensitive to radiation. Accordingly, radiotherapy has long been the primary curative modality for patients with non-metastatic NPC. Although intensity-modulated radiotherapy has significantly improved target conformality and normal tissue protection, local recurrence, distant metastasis, and late toxicity remain important issues in long-term management. To achieve a balance between tumor control and normal tissue protection, the continuous integration of multi-source information throughout the treatment workflow is critical. Radiomics has the potential to quantify spatial heterogeneity that may not be fully captured by conventional visual assessment. In this review, radiomics-driven multimodal integration refers to the task-specific combination of imaging-derived phenotypes with complementary clinical variables, Epstein–Barr virus DNA (EBV-DNA), hematological biomarkers, dose distributions, pathological features, molecular data, longitudinal imaging, or treatment-delivery information for defined radiotherapy decisions. This review focuses on the clinical timeline of precision radiotherapy for NPC and provides an overview of radiomics-driven multimodal integration studies. It discusses the current applications and limitations of this framework in pretreatment risk stratification and treatment selection, target volume and organ-at-risk definition during radiotherapy planning, on-treatment monitoring and adaptive radiotherapy, toxicity prediction and normal-tissue protection, and post-treatment recurrence assessment and re-irradiation decision-making. This synthesis of current evidence, clinical barriers, and methodological considerations may inform future validation and implementation of radiomics-driven multimodal integration in NPC precision radiotherapy.
Related
- Artificial Intelligence, Multi-Omics, and Multimodal Integration in Precision Radiotherapy for Head and Neck Cancer: From Biological Insights to Treatment Decisions
- Multimodal integration of carotid plaque ultrasound radiomics and dynamic systemic immune-inflammation trajectories for subacute risk stratification after stroke thrombectomy: development and internal validation of an exploratory prognostic model
- Development and validation of a metabolic syndrome-based nomogram to predict 1-year metastasis after radiotherapy in locally advanced nasopharyngeal carcinoma
- Longitudinal Delta-Radiomics Identifies Treatment-Fraction-Associated Features Linked to Outcomes After Carbon-Ion Radiotherapy for Head and Neck Cancer
- Efficacy of immediate radiotherapy versus salvage radiotherapy in patients with de novo metastatic nasopharyngeal carcinoma responsive to chemoimmunotherapy
BibTeX
@article{ma2026radiomicsdriven,
title = {{Radiomics-driven multimodal integration in precision radiotherapy for nasopharyngeal carcinoma— current evidence, clinical barriers, and future directions}},
author = {Yuhan Ma and Yuxin Xie and Qitao Gou and Nianyong Chen and Qiheng Gou},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1902266},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1902266},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Radiomics-driven multimodal integration in precision radiotherapy for nasopharyngeal carcinoma— current evidence, clinical barriers, and future directions
AU - Yuhan Ma
AU - Yuxin Xie
AU - Qitao Gou
AU - Nianyong Chen
AU - Qiheng Gou
PY - 2026
DA - 2026/11/04
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1902266
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1902266
AB - Nasopharyngeal carcinoma (NPC), a head and neck malignancy, is highly sensitive to radiation. Accordingly, radiotherapy has long been the primary curative modality for patients with non-metastatic NPC. Although intensity-modulated radiotherapy has significantly improved target conformality and normal tissue protection, local recurrence, distant metastasis, and late toxicity remain important issues in long-term management. To achieve a balance between tumor control and normal tissue protection, the continuous integration of multi-source information throughout the treatment workflow is critical. Radiomics has the potential to quantify spatial heterogeneity that may not be fully captured by conventional visual assessment. In this review, radiomics-driven multimodal integration refers to the task-specific combination of imaging-derived phenotypes with complementary clinical variables, Epstein–Barr virus DNA (EBV-DNA), hematological biomarkers, dose distributions, pathological features, molecular data, longitudinal imaging, or treatment-delivery information for defined radiotherapy decisions. This review focuses on the clinical timeline of precision radiotherapy for NPC and provides an overview of radiomics-driven multimodal integration studies. It discusses the current applications and limitations of this framework in pretreatment risk stratification and treatment selection, target volume and organ-at-risk definition during radiotherapy planning, on-treatment monitoring and adaptive radiotherapy, toxicity prediction and normal-tissue protection, and post-treatment recurrence assessment and re-irradiation decision-making. This synthesis of current evidence, clinical barriers, and methodological considerations may inform future validation and implementation of radiomics-driven multimodal integration in NPC precision radiotherapy.
SN - 2234-943X
ER -