Predicting Radiotherapy Impact on Late Bladder Toxicity in Prostate Cancer Patients: An Observational Study.
Predicting Radiotherapy Impact on Late Bladder Toxicity in Prostate Cancer Patients: An Observational Study.
复制标题
DOI：
10.3390/cancers13020175
复制
发表时间：
2021-01-06
期刊：
影响因子：
5.2
通讯作者：
Mantini G
中科院分区：
文献类型：
--
作者：
Catucci F;Alitto AR;Masciocchi C;Dinapoli N;Gatta R;Martino A;Mazzarella C;Fionda B;Frascino V;Piras A;D'Aviero A;Preziosi F;Palazzoni G;Valentini V;Mantini G
前列腺癌（PC）是70岁以上男性最常见的癌症，具有异质性特征，目前多种治疗策略均可获得最佳结果并提高生存率。个性化医疗和降低发病率治疗的需求正在增加。开发个性化治疗的决策支持系统是肿瘤学的一个关键挑战。这项名为PRODIGE 1.1的研究旨在建立一个模型，分析前列腺癌放疗患者的剂量学参数，预测晚期膀胱毒性，从而定制治疗方案，降低晚期发病率。背景与目的：本研究的目的是建立一种合适的前列腺癌（PC）放疗后膀胱晚期毒性模型。材料和方法：纳入2010年9月至2017年4月期间治疗的PC患者。进行观察性研究，收集任何级别的晚期毒性数据，根据RTOG和CTCAE 4.03量表，导出每位患者的累积剂量体积直方图。通过Mann-Whitney秩和检验分析Vdose，即剂量值对危险器官（OAR）的影响。采用Logistic回归作为最终模型。通过从原始数据集中抽取1000个替换样本并计算AUC平均值来估计模型的性能。此外，采用校正图（Hosmer-Lemeshow拟合优度检验）来评估内部验证的性能。使用的是RStudio软件3.3.1版本和内部开发的软件包“Moddicom”。结果：共收集175例患者资料。中位随访为39个月（最小-最大3.00-113.00）。我们对≥2级晚期膀胱毒性患者亚组进行连续性校正的Mann-Whitney秩和检验：应用logistic回归模型（系数4.3，p值0.025）预测≥2级晚期膀胱毒性的发展，在Vdose为51.43 Gy时，p值有统计学意义。对模型内部验证的性能进行了评估，AUC为0.626。通过绘制校准图来估计精度。结论：我们的初步结果有助于优化治疗计划程序和定制治疗方案。
Prostate cancer (PC) is the most common cancer in men over 70 years old, with heterogeneous characteristics and, nowadays, multiple treatment strategies obtaining optimal outcomes and improving survival. Personalized medicine and even more morbidity treatment reduction are increasing needs. The development of decision support systems to personalize treatments is a key challenge in oncology. The study PRODIGE 1.1 aimed to elaborate on a model analyzing dosimetric parameters in Prostate Cancer patients treating by radiation therapy, predicting late bladder toxicity in order to customize treatments and reduce late morbidity. Background and purpose: The aim of our study was to elaborate a suitable model on bladder late toxicity in prostate cancer (PC) patients treated by radiotherapy with volumetric technique. Materials and methods: PC patients treated between September 2010 and April 2017 were included in the analysis. An observational study was performed collecting late toxicity data of any grade, according to RTOG and CTCAE 4.03 scales, cumulative dose volumes histograms were exported for each patient. Vdose, the value of dose to a specific volume of organ at risk (OAR), impact was analyzed through the Mann–Whitney rank-sum test. Logistic regression was used as the final model. The model performance was estimated by taking 1000 samples with replacement from the original dataset and calculating the AUC average. In addition, the calibration plot (Hosmer–Lemeshow goodness-of-fit test) was used to evaluate the performance of internal validation. RStudio Software version 3.3.1 and an in house developed software package “Moddicom” were used. Results: Data from 175 patients were collected. The median follow-up was 39 months (min–max 3.00–113.00). We performed Mann–Whitney rank-sum test with continuity correction in the subset of patients with late bladder toxicity grade ≥ 2: a statistically significant p-value with a Vdose of 51.43 Gy by applying a logistic regression model (coefficient 4.3, p value 0.025) for the prediction of the development of late G ≥ 2 GU toxicity was observed. The performance for the model’s internal validation was evaluated, with an AUC equal to 0.626. Accuracy was estimated through the elaboration of a calibration plot. Conclusions: Our preliminary results could help to optimize treatment planning procedures and customize treatments.
登录
查看更多内容
影响因子：
7.2
作者：
Collins, Gary S.;Reitsma, Johannes B.;Moons, Karel G. M.
通讯作者：
Moons, Karel G. M.
影响因子：
8.4
作者：
Arnold, Melina;Karim-Kos, Henrike E.;Soerjomataram, Isabelle
通讯作者：
Soerjomataram, Isabelle
影响因子：
23.4
作者：
Jacobs BL;Zhang Y;Skolarus TA;Wei JT;Montie JE;Miller DC;Hollenbeck BK
通讯作者：
Hollenbeck BK
影响因子：
5.7
作者：
NIEMIERKO, A;GOITEIN, M
通讯作者：
GOITEIN, M
影响因子：
5.7
作者：
De Langhe, Sofie;De Meerleer, Gert;Thierens, Hubert
通讯作者：
Thierens, Hubert