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开发和验证一种新型预测模型,用于从西斯普拉丁化疗中听力损失
Joshua Millstein1, Shahrad R Rassekh2,3, Austin L Brown4
1University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA.
概括
这项研究开发了PedsHEAR模型,用于预测治疗 cisplatin 化疗的儿童和青少年的听力损失 (HL). 经过验证的模型准确地识别了患有这种衰弱副作用的高风险患者.
科学领域:
- 在瘤学瘤学.
- 耳毒性研究研究 耳毒性研究
- 机器学习在医学中的应用
背景情况:
- 西斯是许多癌症的重要化疗剂.
- 在儿科患者中,西斯普拉丁治疗经常导致永久性,衰弱性听力损失 (HL).
- 准确预测HL风险对于管理年轻癌症幸存者的治疗毒性至关重要.
研究的目的:
- 在儿童和青少年癌症幸存者中开发和外部验证西斯普拉丁诱导的听力损失 (HL) 的预测模型.
- 确定高风险患有影响沟通的HL的儿童和青少年.
- 改善接受西斯的患者的临床管理和支持性护理.
主要方法:
- 听力风险的儿科整体评估 (PedsHEAR) 模型是使用机器学习和集合预测开发的.
- 该模型在一个大型的多中心数据集上进行了训练,该数据集包括暴露于西斯普拉丁的21岁以下的患者.
- 外部验证使用来自多个机构和临床试验的独立数据集进行.
主要成果:
- 在培训组中,PedsHEAR模型表现出强大的预测性能,AUC为0.93.
- 内部和外部验证队列显示出良好的区别 (AUC从0.67到0.79不等).
- 该模型有效地将患者分为低风险,中等风险和高风险类别,用于开发SIOP等级≥2 HL.
结论:
- 该PedsHEAR模型准确地预测了儿童癌症患者的西斯普拉丁诱导的听力损失 (SIOP等级≥2).
- 这代表了第一个验证的模型,用于预测在多样化的儿科群体中西斯的耳毒性.
- PedsHEAR为儿童瘤学中的积极风险评估和个性化护理提供了一个有价值的工具.
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