A novel nomogram to predict overall survival in head and neck cancer survivors with radiation-induced brain necrosis
A novel nomogram to predict overall survival in head and neck cancer survivors with radiation-induced brain necrosis
复制标题
一种新颖的列线图来预测放射引起的脑坏死的头颈癌幸存者的总体生存率
DOI：
10.1016/j.radonc.2022.01.033
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发表时间：
2022-03-01
影响因子：
5.7
通讯作者：
Tang, Yamei
中科院分区：
文献类型：
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作者：
Pan, Dong;Rong, Xiaoming;Tang, Yamei
背景和目的：本研究旨在开发和验证一种新的列线图，以预测诊断为放射引起的脑坏死 (RN) 后头颈癌幸存者的总体生存率。材料和方法：我们纳入了来自放射并发症登记研究的头颈癌幸存者和 RN。总共 495 名符合条件的患者按 7:3 随机分配到训练队列和内部验证队列。应用最小绝对收缩和选择算子 (LASSO) 回归来选择训练队列中 RN 后生存的显着预测因子，并使用多变量 Cox 模型来开发列线图。使用内部验证队列评估列线图的性能，并使用另外 88 名 RN 患者进行外部验证。结果：我们使用训练数据确定了 RN 后生存的五个预测因素：年龄、RN 前肿瘤进展、下颅神经损伤、双侧坏死和中风病史。列线图在内部验证队列（C 指数 0.761，95% CI 0.676 至 0.847）和外部验证队列（C 指数 0.795，95% CI 0.717 至 0.874）中显示出良好的性能。决策曲线分析表明，当被诊断为 RN 后，当 1 年死亡概率为 1% 至 48%、3 年死亡概率为 3% 至 50%、5 年死亡概率超过 2% 时，列线图在临床上是有用的。 结论：在这项基于 LASSO-Cox 模型的列线图研究中，我们开发并验证了一种易于应用的模型，用于预测 RN 诊断后头颈癌幸存者的总生存期。 (C) 2022 Elsevier B.V. 保留所有权利。
Background and purpose: The study aimed to develop and validate a novel nomogram to predict overall survival in head and neck cancer survivors following the diagnosis of radiation-induced brain necrosis (RN).Materials and methods: We included head and neck cancer survivors with RN from a radiation complications registry study. A total of 495 eligible patients were 7:3 randomly allocated to a training cohort and an internal validation cohort. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to select significant predictors of post-RN survival in the training cohort, and a multivariable Cox model was used to develop the nomogram. The performance of the nomogram was assessed using the internal validation cohort and externally validated using additional 88 RN patients.Results: We identified five predictors of post-RN survival using the training data: age, tumor progression before RN, lower cranial nerves injury, bilateral necrosis, and history of stroke. The nomogram showed favorable performance in the internal validation cohort (C-index 0.761, 95% CI 0.676 to 0.847) and in the external validation cohort (C-index 0.795, 95% CI 0.717 to 0.874). The decision curve analysis indicated that the nomogram was clinically useful when the probabilities of death ranging from 1% to 48% at 1 year, from 3% to 50% at 3 years, and exceeding 2% at 5 years after being diagnosed with RN.Conclusion: In this LASSO-Cox model-based nomogram study, we developed and validated an easily applied model to predict overall survival in head and neck cancer survivors following an RN diagnosis. (C) 2022 Elsevier B.V. All rights reserved.