Nomogram for radiation-induced hypothyroidism prediction in nasopharyngeal carcinoma after treatment
Nomogram for radiation-induced hypothyroidism prediction in nasopharyngeal carcinoma after treatment
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DOI：
10.1259/bjr.20160686
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发表时间：
2017-01-01
影响因子：
2.6
通讯作者：
Lin, Zhixiong
中科院分区：
文献类型：
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作者：
Luo, Ren;Li, Mei;Lin, Zhixiong
目的：本研究的目的是建立一个诺模图的放射性甲状腺功能减退症（RHT）prediction.Methods：我们收集了164例鼻咽癌（NPC）患者在我们以前的前瞻性研究的数据。生化甲状腺功能减退症定义为血清促甲状腺激素水平高于正常值。我们收集了临床和剂量体积因素。进行单变量考克斯回归分析，以确定RHT的危险因素。根据最小绝对收缩和选择算子（LASSO）选择最佳预测因子。然后，我们选择的考克斯回归模型，最好的平衡的预测性能和实用性，建立一个诺模图为RHT prediction.Results：有38例（23.2%）患者发展RHT，中位随访时间为24个月。单因素考克斯回归分析显示，性别、最小剂量、平均剂量（D-mean）和甲状腺体积> x戈伊的百分比（V-x（%））与RHT显著相关。选择性别、是否接受化疗（化疗）、Dmean和V-50等变量进行LASSO分析。构建了基于三变量（性别、化疗和V-50）的考克斯回归模型的列线图，其一致性指数为0.72。预测和观察之间的良好一致性显示校准曲线在RHT的概率在18，24和30 month.Conclusion：本研究建立了诺模图的RHT在NPC幸存者通过分析临床和剂量体积参数使用LASSO。因此，可以以视觉形式实现个体剂量约束。
Objective: The aim of this study was to develop a nomogram for radiation-induced hypothyroidism (RHT) prediction.Methods: We collected data from 164 patients with nasopharyngeal carcinoma (NPC) in our previous prospective study. Biochemical hypothyroidism was defined as a serum thyroid-stimulating hormone level greater than the normal value. We collected both clinical and dose-volume factors. A univariate Cox regression analysis was performed to identify RHT risk factors. Optimal predictors were selected according to the least absolute shrinkage and selection operator (LASSO). We then selected the Cox regression models that best balanced the prediction performance and practicability to build a nomogram for RHT prediction.Results: There were 38 (23.2%) patients who developed RHT, and the median follow-up was 24 months. The univariate Cox regression analysis indicated that gender, minimum dose, mean dose (D-mean) and V-25-V-60 [V-x (%), the percentage of thyroid volume receiving > x Gy] of the thyroid were significantly associated with RHT. The variables of gender, receiving chemotherapy or not (chemo), Dmean and V-50 were selected using the LASSO analysis. A nomogram based on a three-variable (gender, chemo and V-50) Cox regression model was constructed, and its concordance index was 0.72. Good accordance between prediction and observation was showed by calibration curves in the probability of RHT at 18, 24 and 30 months.Conclusion: This study built a nomogram for RHT in NPC survivors by analyzing both clinical and dose-volume parameters using LASSO. Thus, the individual dose constraint could be achieved in a visual format.