Toward a model-based patient selection strategy for proton therapy: External validation of photon-derived normal tissue complication probability models in a head and neck proton therapy cohort.
Toward a model-based patient selection strategy for proton therapy: External validation of photon-derived normal tissue complication probability models in a head and neck proton therapy cohort.
复制标题
DOI：
10.1016/j.radonc.2016.08.022
复制
发表时间：
2016-12
期刊：
影响因子：
--
通讯作者：
Frank SJ
中科院分区：
文献类型：
--
作者：
Blanchard P;Wong AJ;Gunn GB;Garden AS;Mohamed ASR;Rosenthal DI;Crutison J;Wu R;Zhang X;Zhu XR;Mohan R;Amin MV;Fuller CD;Frank SJ
在接受质子束治疗（PBT）的患者中外部验证头颈癌（HNC）光子衍生正常组织并发症概率（NTCP）模型。该前瞻性队列由在单一机构接受PBT治疗的HNC患者组成。根据验证数据的可用性选择NTCP模型，并使用受试者工作特征曲线的留一交叉验证曲线下面积（AUC）进行评价。共纳入192例患者。最常见的肿瘤部位是口咽（n=86，45%），其次是鼻窦（n=28）、鼻咽（n=27）或腮腺（n=27）肿瘤。除了急性粘膜炎的预测（AUC降低0.17）外，模型总体表现良好。对于PBT后6个月的饲管，验证（PBT）AUC和公布的AUC分别为0.90和0.88;对于PBT后6个月的医生评定的吞咽困难，验证（PBT）AUC和公布的AUC分别为0.70和0.80;对于PBT后6个月的口干，验证（PBT）AUC和公布的AUC分别为0.70和0.80;对于PBT后12个月的甲状腺功能减退，验证（PBT）AUC和公布的AUC分别为0.73和0.85。虽然NTCP模型性能在PBT患者中的下降是预期的，但模型显示出稳健性并保持有效。进一步的工作是必要的，但这些结果支持基于模型的方法用于HNC患者治疗选择的有效性。
To externally validate head and neck cancer (HNC) photon-derived normal tissue complication probability (NTCP) models in patients treated with proton beam therapy (PBT). This prospective cohort consisted of HNC patients treated with PBT at a single institution. NTCP models were selected based on the availability of data for validation and evaluated using the leave-one-out cross-validated area under the curve (AUC) for the receiver operating characteristics curve. 192 patients were included. The most prevalent tumor site was oropharynx (n=86, 45%), followed by sinonasal (n=28), nasopharyngeal (n=27) or parotid (n=27) tumors. Apart from the prediction of acute mucositis (reduction of AUC of 0.17), the models overall performed well. The validation (PBT) AUC and the published AUC were respectively 0.90 versus 0.88 for feeding tube 6 months post-PBT; 0.70 versus 0.80 for physician rated dysphagia 6 months post-PBT; 0.70 versus 0.80 for dry mouth 6 months post-PBT; and 0.73 versus 0.85 for hypothyroidism 12 months post-PBT. While the drop in NTCP model performance was expected in PBT patients, the models showed robustness and remained valid. Further work is warranted, but these results support the validity of the model-based approach for treatment selection for HNC patients.