在现实世界人口中验证的异口症预测:迈向模型导向放射治疗的一步
Emmy Dalqvist1, Tiziana Rancati2, Anna Embring3
1Department of Oncology Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Nuclear Medicine and Medical Physics, Karolinska University Hospital, Stockholm, Sweden. emmy.dalqvist@ki.se.
Acta oncologica (Stockholm, Sweden)
|August 18, 2025
概括
这项研究验证了异位形成的正常组织并发症概率 (NTCP) 模型,表明它可以重新校准以进行个性化放射治疗计划. 该模型有效地预测并发症,即使没有基线数据.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 临床信息学 临床信息学
背景情况:
- 异口症 (口腔干燥) 是放射治疗后的一个常见并发症.
- 准确预测异口症对于个性化治疗规划至关重要.
- 正常组织并发症概率 (NTCP) 模型有助于预测这些不良影响.
研究的目的:
- 为了验证现有的NTCP模型对异位.
- 评估模型在大量现实世界质量注册表队列中的表现.
- 确定使用该模型进行基于NTCP的个性化放射治疗规划的可行性.
主要方法:
- 用腺和下下腺剂量验证2级≥2级异口症的预测模型.
- 在2012年至2024年期间接受治疗的674名患者队列的分析.
- 使用校准曲线,歧视指标,Brier分数和Hosmer-Lemeshow测试进行性能评估.
主要成果:
- 最初的模型显示了良好的剂量反应预测,但由于显著偏差 (HL-test) 需要重新校准.
- 再校准导致了完美的校准,但差异性有限 (AUC 0.62).
- 该模型在现实生活数据集中显示出强度,尽管与培训队伍的差异不同.
结论:
- 经过验证和重新校准的NTCP模型显示了个性化放射治疗治疗规划的潜力.
- 包括基线异位体得分可以进一步提高模型性能.
- 这项研究支持开发基于NTCP的协议来管理异口症.
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