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Updated: May 13, 2025

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外部验证的数字决策支持工具,用于使用正确审查的多机构观察队列进行时间到骨性放射性死风险分层

Laia Humbert-Vidan¹, Serageldin Kamel², Andrew Wentzel³

¹The University of Texas MD Anderson Cancer Center, Houston, TX, USA; King's College London, London, UK.

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

|April 13, 2025

概括

这项研究模拟了头癌幸存者的骨放射性死 (ORNJ) 的时间,确定男性性别,辐射前牙提取和辐射剂量作为早期发病的关键预测因素.

科学领域:

在瘤学瘤学.
辐射瘤学辐射瘤学
口腔和牙面部外科手术

背景情况:

目前关于骨放射性死 (ORNJ) 的研究主要使用横截面数据,这限制了对时间风险的理解.
确定ORNJ的时间到事件概况对于长期监测头癌 (HNC) 幸存者的口腔健康至关重要.

研究的目的:

开发和验证ORNJ的时间到事件配置文件的预测模型.
确定ORNJ发作的关键剂量测量,临床和人口预测因素.
通过一个用户友好的界面来促进临床实施.

主要方法:

对1129名接受放射治疗 (RT) 的HNC患者和198例ORNJ病例的临床观察队列的回顾性分析.
开发和内部验证Weibull加速失效时间模型,使用剂量计,临床和人口统计数据.
在265名患者 (92名ORNJ病例) 的独立队列上进行外部验证,并对开发的图形用户界面 (GUI) 进行可用性测试.

主要成果:

该模型确定了男性性别,RT前的牙提取和D25%的辐射剂量与ORNJ的更快发病有显著的关联.
调整后的时间比率表明男性的发病速度更快 (0.62),RT前提取 (0.73) 和D25% (0.88).
该模型表现出强大的内部校准 (布赖尔分数0.133,D-校准p=0.998) 和歧视 (C指数0.72在72个月).

结论:

这项研究是第一个在辐射剂量和ORNJ发作的时间之间建立直接关系的研究.
这些发现为辐射剂量和患者因素如何影响ORNJ的时间,即晚期辐射效应,提供了新的描述.
该模型提供了对生存期间条件风险的见解,不仅仅是发展ORNJ的概率.

关键词:

决策支持工具决策支持工具头部和部癌症头部和部癌症正常组织并发症预测和预测.骨的骨质放射性死 (Osteoradionecrosis) 在下巴.辐射诱导的毒性辐射诱导的毒性辐射疗法辐射疗法时间到事件的预测模型.

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