Complication probability models for radiation-induced heart valvular dysfunction: do heart-lung interactions play a role?
Complication probability models for radiation-induced heart valvular dysfunction: do heart-lung interactions play a role?
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DOI：
10.1371/journal.pone.0111753
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Pacelli R
中科院分区：
文献类型：
--
作者：
Cella L;Palma G;Deasy JO;Oh JH;Liuzzi R;D'Avino V;Conson M;Pugliese N;Picardi M;Salvatore M;Pacelli R
本研究的目的是比较不同的正常组织并发症概率(NTCP)模型预测胸部照射后心脏瓣膜功能不全(RVD)。我们机构霍奇金淋巴瘤幸存者数据库中的所有患者都包括在可分析的数据集中(n = 90)。所有患者均接受三维适形放射治疗，中位总剂量为32Gy.每个患者的心脏毒性档案都是可用的。提取心脏和肺的剂量-体积直方图(DVH)，并考虑两个器官的Lyman-Kutcher-Burman(LKB)和相对序贯(RS)NTCP模型，采用最大似然估计进行模型拟合。采用Bootstrap拟合法检验模型拟合的稳健性。使用接收器工作特性曲线(AUC)下的面积来评估模型的性能。仅使用心脏DVH，LKB模型的参数估计为：D50 = 32.8GY，n = 0.16，m = 0.67；RS模型：D50 = 32.4GY，S = 0.99，γ = 0.42。LKB和RS的AUC值分别为0.67和0.66。仅使用肺DVH的模型也获得了类似的效果(LKB：D50 = 33.2Gy，n = 0.01，m = 0.19，AUC = 0.68；RS：D50 = 24.4Gy，S = 0.99，γ = 2.12，AUC = 0.66)。Bootstrap结果表明，该参数对肺-LKB的拟合是非常稳健的。心肺联合LKB模型也被测试，并显示出轻微的改善(AUC = 0.70)。然而，使用先前确定的包括最大心脏剂量和增加较大心脏和较小肺容量的风险的多元回归模型获得了最佳性能(AUC = 0.82)。仅基于心脏剂量-体积分布的NTCP模型不能对辐射引起的瓣膜疾病的风险进行建模。可以得到一个性能更好的预测模型，但需要包括心肺体积项，这表明心肺相互作用显然对这一终点很重要。
The purpose of this study is to compare different normal tissue complication probability (NTCP) models for predicting heart valve dysfunction (RVD) following thoracic irradiation. All patients from our institutional Hodgkin lymphoma survivors database with analyzable datasets were included (n = 90). All patients were treated with three-dimensional conformal radiotherapy with a median total dose of 32 Gy. The cardiac toxicity profile was available for each patient. Heart and lung dose-volume histograms (DVHs) were extracted and both organs were considered for Lyman-Kutcher-Burman (LKB) and Relative Seriality (RS) NTCP model fitting using maximum likelihood estimation. Bootstrap refitting was used to test the robustness of the model fit. Model performance was estimated using the area under the receiver operating characteristic curve (AUC). Using only heart-DVHs, parameter estimates were, for the LKB model: D50 = 32.8 Gy, n = 0.16 and m = 0.67; and for the RS model: D50 = 32.4 Gy, s = 0.99 and γ = 0.42. AUC values were 0.67 for LKB and 0.66 for RS, respectively. Similar performance was obtained for models using only lung-DVHs (LKB: D50 = 33.2 Gy, n = 0.01, m = 0.19, AUC = 0.68; RS: D50 = 24.4 Gy, s = 0.99, γ = 2.12, AUC = 0.66). Bootstrap result showed that the parameter fits for lung-LKB were extremely robust. A combined heart-lung LKB model was also tested and showed a minor improvement (AUC = 0.70). However, the best performance was obtained using the previously determined multivariate regression model including maximum heart dose with increasing risk for larger heart and smaller lung volumes (AUC = 0.82). The risk of radiation induced valvular disease cannot be modeled using NTCP models only based on heart dose-volume distribution. A predictive model with an improved performance can be obtained but requires the inclusion of heart and lung volume terms, indicating that heart-lung interactions are apparently important for this endpoint.
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DOI：
10.1186/1748-717x-8-22
发表时间：
2013-01-30
期刊：
Radiation oncology (London, England)
影响因子：
--
作者：
Cella L;Conson M;Pressello MC;Molinelli S;Schneider U;Donato V;Orecchia R;Salvatore M;Pacelli R
通讯作者：
Pacelli R
DOI：
10.1016/j.ijrobp.2009.04.093
发表时间：
2010-01-01
影响因子：
7
作者：
Gagliardi, Giovanna;Constine, Louis S.;Marks, Lawrence B.
通讯作者：
Marks, Lawrence B.
影响因子：
3.8
作者：
Deasy, JO;Blanco, AI;Clark, VH
通讯作者：
Clark, VH
DOI：
10.3109/0284186x.2010.521192
发表时间：
2011-01
期刊：
Acta oncologica (Stockholm, Sweden)
影响因子：
--
作者：
Huang EX;Hope AJ;Lindsay PE;Trovo M;El Naqa I;Deasy JO;Bradley JD
通讯作者：
Bradley JD
影响因子：
5.7
作者：
Eriksson, F;Gagliardi, G;Rutqvist, LE
通讯作者：
Rutqvist, LE