Pretreatment nomogram for predicting the outcome of three-dimensional conformal radiotherapy in prostate cancer
Pretreatment nomogram for predicting the outcome of three-dimensional conformal radiotherapy in prostate cancer
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DOI：
10.1200/jco.2000.18.19.3352
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发表时间：
2000-10-01
影响因子：
45.3
通讯作者：
Leibel, SA
中科院分区：
文献类型：
--
作者：
Kattan, MW;Zelefsky, MJ;Leibel, SA
目的：几项研究已经确定了预测局限性前列腺癌外照射放射治疗结果的危险组。然而，大多数模型形成了患者风险组，这些模型中没有一个将辐射剂量作为预测变量。材料和方法：本研究是对1988年至1998年在纪念斯隆-凯特琳癌症中心治疗的1042例患者进行的非随机回顾性分析，包括分期、活检Gleason评分、治疗前血清前列腺特异性抗原(PSA)水平、是否接受新辅助雄激素剥夺治疗以及接受的放射剂量。当血清PSA连续三次升高时，对生化(PSA)治疗失败进行评分。用ct bootstrapping方法对该数据集进行了内部验证，并使用在俄亥俄州克利夫兰克利夫兰诊所接受治疗的患者的队列进行了外部验证。结果：当从克利夫兰诊所验证数据集中预测患者的结果时，该诺模图的预测失败时间与观察失败时间之间的ct Somers‘s D等级相关为0.52。这个诺模图的预测更准确(P
Purpose: Several studies have defined risk groups for predicting the outcome after external-beam radiotherapy of localized prostate cancer. However, most models formed patient risk groups, and none of these models considers radiation dose as a predictor variable. The purpose of this study was to develop a nomogram to improve the accuracy of predicting outcome after three-dimensional conformal radiotherapy.Materials and Methods:This study was a retrospective, nonrandomized analysis of patients treated at the Memorial Sloan-Kettering Cancer Center between 1988 and 1998, Clinical parameters of the 1,042 patients included stage, biopsy Gleason score, pretreatment serum prostate-specific antigen (PSA) level, whether neoadjuvant androgen deprivation therapy was administered, and the radiation dose delivered. Biochemical (PSA) treatment failure was scored when three consecutive rises of serum PSA occurred. A nomogram, which predicts the probability of remaining free from biochemical recurrence for 5 years, was validated internally on this data set using ct bootstrapping method and externally using a cohort of patients treated at the Cleveland Clinic, Cleveland, OH.Results: When predicting outcomes for patients in the validation data set from the Cleveland Clinic, the nomogram had ct Somers' D rank correlation between predicted and observed failure times of 0.52. Predictions from this nomogram were more accurate (P