Time-to-Event Supervised Genetic Algorithm Enables Induction Chemotherapy Decision Making for Nasopharyngeal Carcinoma

Do nasopharyngeal carcinoma (NPC) patients benefit from induction chemotherapy (IC)? This problem is of great clinical interest; however, it is difficult to obtain an accurate and interpretable model to inform IC decisions for NPC patients. In this study, a time-to-event supervised genetic algorithm was developed to obtain an IC decision-making model for NPC patients. In this algorithm, the fitness function is directly related to the time-to-event, which reflects the IC therapeutic effect for NPC. Then, the optimal models are obtained by stability and validation analysis. The comprehensive clinical model is determined by comprehensive feature analysis using the “or” operation. The overall survival for non-IC vs. IC patients in the potential benefit group was 63.4% vs. 81.5%, with p = 0.020, and the comprehensive clinical model exhibited good generalization ability. However, the benefits of OS according to the current NCCN guidelines are limited (p > 0.05). None of the possible processes of LASSO we tried could obtain the significant models validated in the testing cohort. The proposed method provides an interpretable model construction process, reasonable data grouping strategy, concise experimental design, and convenient clinical application. Moreover, we will develop a toolkit for the treatment decision-making model research to facilitate the use of clinicians and provide technical support for precision medicine.