A prospective cohort study of hepatic toxicity after stereotactic body radiation therapy for hepatocellular carcinoma.
Radiother Oncol
; 129(1): 136-142, 2018 10.
Article
em En
| MEDLINE
| ID: mdl-29548558
ABSTRACT
PURPOSE:
To build and validate multivariate normal tissue complication probability (NTCP) models for radiation-induced hepatic toxicity (RIHT) after stereotactic body radiation therapy (SBRT).METHODS:
Eighty-five patients with hepatocellular carcinoma (HCC) in a phase II clinical trial were enroled. A progression of at least 1 or 2 points in the Child-Pugh (CP) score post-SBRT was classified as RIHT (≥1 or ≥2). NTCP models for RIHT (≥1 or ≥2) were developed using logistic regression. Nomograms for each model were formulated. The cut-off point of each independent dosimetric risk factor was obtained using receiver-operating characteristic (ROC) analysis. We used an independent cohort (101 patients) for model validation.RESULTS:
Twenty (23.5%) and 12 (14.2%) patients experienced RIHT (≥1) and RIHT (≥2), respectively. V15, VS10, and pretreatment CP (pre-CP) were the optimal predictors for RIHT (≥1 and ≥2) modelling. V15 ≤33.1% and VS10 ≥416.2â¯mL for RIHT (≥1), and V15 ≤21.5% and VS10 ≥621.8â¯mL for RIHT (≥2), were the cut-off points. Four NTCP models and their nomograms were generated. These models and nomograms showed good prediction performance (area under the curve (AUC), 0.83-0.89). Our NTCP model (RIHT ≥2) based on V15 plus pre-CP performed well (AUCâ¯=â¯0.78) in a validation cohort.CONCLUSION:
V15, VS10, and pre-CP are crucial predictors for RIHT (≥1 and ≥2). Our NTCP models and nomograms were conducive to obtain individual constraints for patients with HCC. REGISTRATION NUMBER ChiCTR-IIC-16008233.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Radiocirurgia
/
Carcinoma Hepatocelular
/
Neoplasias Hepáticas
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Radiother Oncol
Ano de publicação:
2018
Tipo de documento:
Article