局部乳腺癌老年人群的辅助治疗策略决策支持:一个单心队列回顾性研究
Julia L Fleck1, Daniëlle Hooijenga1, Raksmey Phan1
1Mines Saint-Etienne, Univ Clermont Auvergne, CNRS, UMR 6158 LIMOS, Centre CIS, Saint-Etienne, France.
PloS one
|August 24, 2023
概括
一个新的决策工具有助于确定老年乳腺癌患者的辅助治疗方法. 没有自编码的逻辑回归最好地预测了辅助治疗的需要,改善了治疗决策.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 生物医学信息学 生物医学信息学
背景情况:
- 对早期乳腺癌的老年患者的管理指南有限.
- 老年人的并发症使得手术后辅助系统治疗的决策变得复杂.
- 在非转移性环境中的不确定性往往导致治疗不足和不良结果.
研究的目的:
- 为老年乳腺癌患者选择辅助性术后治疗方案开发决策支持工具.
- 根据瘤和患者特征预测各种治疗选择的患者结果.
- 为新老年乳腺癌患者的临床决策提供信息.
主要方法:
- 利用了早期乳腺癌患者的老年患者 (≥70岁) 队列,以治愈意图进行治疗.
- 使用5倍交叉验证 (80%的培训,20%的测试) 训练并测试了七个分类算法.
- 在分类之前使用了自动编码器来减少维度;通过准确性,精度,回忆,F1得分和AUC得分来评估性能.
主要成果:
- 逻辑回归和线性差异分析模型在与其他测试算法相比显示出更高的性能.
- 自动编码通常提高了分类性能,除非预测需要辅助治疗.
- 没有自编码的逻辑回归模型在预测辅助治疗的需要方面取得了最佳表现 (F1得分 = 0.869).
结论:
- 一个预测模型,特别是逻辑回归,可以有效地指导老年乳腺癌患者的辅助治疗决策.
- 开发的工具解决了指导方针的稀缺性和伴随性疾病在这个人群中带来的挑战.
- 基于患者和瘤特征的优化治疗选择可能会减轻治疗不足并改善结果.
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