现代放疗时代鼻咽癌放射性甲状腺功能减退的多变量正常组织并发症概率预测模型

IF 1.9 4区 医学 Q2 BIOLOGY Journal of Radiation Research Pub Date : 2024-01-19 DOI:10.1093/jrr/rrad091
Siriporn Wongwattananard, Anussara Prayongrat, Natchalee Srimaneekarn, Anthony Hayter, Jiratchaya Sophonphan, Seksan Kiatsupaibul, Puvarith Veerabulyarith, Yothin Rakvongthai, Napat Ritlumlert, Sarin Kitpanit, Danita Kannarunimit, Chawalit Lertbutsayanukul, Chakkapong Chakkabat
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引用次数: 0

摘要

放射性甲状腺功能减退(RHT)是鼻咽癌(NPC)幸存者常见的长期并发症。使用临床和剂量学因素预测RHT风险的模型可以为个体水平的治疗计划提供适当的剂量-体积参数。我们的目标是建立一个多变量正常组织并发症概率(NTCP)模型,用于鼻咽癌患者在调强放疗或体积调弧治疗后的RHT。该模型采用回顾性临床数据和甲状腺和垂体的剂量-体积数据,基于标准的向后逐步多变量logistic回归分析,然后使用10倍交叉验证进行内部验证。最终的NTCP模型包括年龄、预处理促甲状腺激素和平均甲状腺剂量。模型性能良好,内部(200例)和外部(25例)验证的受试者工作特征曲线下面积分别为0.749和0.812。由于RHT发生率为2%,而>45 Gy组为61%,因此建议采用≤45 Gy的甲状腺平均剂量作为治疗方案。
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A multivariable normal tissue complication probability model for predicting radiation-induced hypothyroidism in nasopharyngeal carcinoma patients in the modern radiotherapy era.

Radiation-induced hypothyroidism (RHT) is a common long-term complication for nasopharyngeal carcinoma (NPC) survivors. A model using clinical and dosimetric factors for predicting risk of RHT could suggest a proper dose-volume parameters for the treatment planning in an individual level. We aim to develop a multivariable normal tissue complication probability (NTCP) model for RHT in NPC patients after intensity-modulated radiotherapy or volumetric modulated arc therapy. The model was developed using retrospective clinical data and dose-volume data of the thyroid and pituitary gland based on a standard backward stepwise multivariable logistic regression analysis and was then internally validated using 10-fold cross-validation. The final NTCP model consisted of age, pretreatment thyroid-stimulating hormone and mean thyroid dose. The model performance was good with an area under the receiver operating characteristic curve of 0.749 on an internal (200 patients) and 0.812 on an external (25 patients) validation. The mean thyroid dose at ≤45 Gy was suggested for treatment plan, owing to an RHT incidence of 2% versus 61% in the >45 Gy group.

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来源期刊
CiteScore
3.60
自引率
5.00%
发文量
86
审稿时长
4-8 weeks
期刊介绍: The Journal of Radiation Research (JRR) is an official journal of The Japanese Radiation Research Society (JRRS), and the Japanese Society for Radiation Oncology (JASTRO). Since its launch in 1960 as the official journal of the JRRS, the journal has published scientific articles in radiation science in biology, chemistry, physics, epidemiology, and environmental sciences. JRR broadened its scope to include oncology in 2009, when JASTRO partnered with the JRRS to publish the journal. Articles considered fall into two broad categories: Oncology & Medicine - including all aspects of research with patients that impacts on the treatment of cancer using radiation. Papers which cover related radiation therapies, radiation dosimetry, and those describing the basis for treatment methods including techniques, are also welcomed. Clinical case reports are not acceptable. Radiation Research - basic science studies of radiation effects on livings in the area of physics, chemistry, biology, epidemiology and environmental sciences. Please be advised that JRR does not accept any papers of pure physics or chemistry. The journal is bimonthly, and is edited and published by the JRR Editorial Committee.
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