Zhang W, Li X, Lin T, Ma F, Ma X, Wu X, Sun Y, Sun X. A model to guide the management and decision of re-planning during radiotherapy for cervical cancer.
Transl Cancer Res 2021;
10:5352-5363. [PMID:
35116382 PMCID:
PMC8797880 DOI:
10.21037/tcr-21-2545]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND
To establish a model to predict whether re-planning is needed in the process of cervical cancer radiotherapy.
METHODS
We collected the clinical indexes of 132 patients diagnosed with cervical cancer receiving concurrent chemotherapy and radiotherapy, including 33 factors about tumor markers [carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125), squamous cell carcinoma antigen (SCC)], tumor volume, rectal volume, bladder volume, volumes receiving 30-50 Gy in organs-at-risk (OARs), and the maximum dose (Dmax) received by 1-2 cc in OARs. We established a multivariate model for re-planning evaluation via principal component analysis, and then verified the model based on the internal data.
RESULTS
We identified the dose index (P1), tumor size index (P2), and volumes receiving 30-50 Gy in OARs and the tumor (P3) as the three most weighted factors of the re-planning model. We set the cut-off for the re-planning modification requirement at 1. The model was consistent with R = 0.12P1 + 0.21P2 + 0.31P3, and it performed accurately that area under the test set characteristics curve (AUC) =0.826].
CONCLUSIONS
Our proposed method can help to reduce image re-examination during treatment, decrease toxicities in OARs, shorten the radiotherapy course, lessen oncologists' efforts, and save medical resources.
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