Construction and validation of a nomogram prediction model for predicting the risk of chemotherapy-induced myelosuppression after chemotherapy in patients with triple-negative breast cancer: a single-center retrospective case-control study.

IF 1.5 4区 医学 Q4 ONCOLOGY
Translational cancer research Pub Date : 2025-05-30 Epub Date: 2025-05-27 DOI:10.21037/tcr-24-1513
Haoling Xie, Rong Zhang, Chunmei Wei, Jinsong Xu, Jie Chu, Xuexing Wang
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引用次数: 0

Abstract

Background: Triple-negative breast cancer (TNBC) has a poor prognosis due to limited targeted treatments. Chemotherapy often causes chemotherapy-induced myelosuppression (CIM), complicating treatment and raising costs, yet predictive tools for this risk are scarce. This study examined the prevalence and risk factors of CIM in TNBC patients after chemotherapy and created nomograms to predict this risk.

Methods: Nomograms were developed from a retrospective study of 316 TNBC patients treated at the Anning First People's Hospital Affiliated to Kunming University of Science and Technology between 1 July 2021 and 31 May 2024. The patients were split into development and validation cohorts in an 8:2 ratio. Least absolute shrinkage and selection operator (LASSO) identified risk factors for CIM, which were used to create the nomograms. The models' accuracy, calibration, and clinical utility were evaluated using the area under the curve (AUC), calibration curves, and decision curve analysis (DCA), with validation through bootstrapping.

Results: In this study of 316 TNBC patients, 102 experienced CIM, an incidence rate of 32.28%. Patient characteristics were similar across cohorts. The development cohort had a mean age of 52.05 years, with a median hospital stay of 5 days. Myelosuppression of degree I was the most common CIM event. LASSO and logistic regression analyses linked CIM to factors like bone metastasis, platinum regimens, chemotherapy cycles, pre-chemotherapy neutrophil count, and drug combinations. The nomograms showed strong predictive accuracy with AUCs of 0.886 [95% confidence interval (CI): 0.836-0.937] and 0.905 (95% CI: 0.834-0.976) in the development and validation cohorts, respectively, and high agreement in calibration curves. DCA confirmed their clinical utility.

Conclusions: This study developed a validated nomogram that accurately predicts the risk of CIM in TNBC patients, helping healthcare providers create personalized treatment plans.

三阴性乳腺癌患者化疗后化疗诱导骨髓抑制风险的nomogram预测模型的构建与验证:一项单中心回顾性病例对照研究
背景:三阴性乳腺癌(TNBC)由于靶向治疗有限,预后较差。化疗经常引起化疗诱导的骨髓抑制(CIM),使治疗复杂化并增加费用,然而这种风险的预测工具很少。本研究检查了化疗后TNBC患者中CIM的患病率和危险因素,并创建了nomogram来预测这种风险。方法:对2021年7月1日至2024年5月31日在昆明理工大学附属安宁第一人民医院接受治疗的316例TNBC患者进行回顾性研究。患者按8:2的比例分为开发组和验证组。最小绝对收缩和选择算子(LASSO)确定了CIM的风险因素,用于创建norm图。使用曲线下面积(AUC)、校准曲线和决策曲线分析(DCA)评估模型的准确性、校准和临床实用性,并通过bootstrapping进行验证。结果:本组316例TNBC患者中,有102例发生了CIM,发生率为32.28%。不同队列的患者特征相似。发展队列的平均年龄为52.05岁,中位住院时间为5天。I级骨髓抑制是最常见的CIM事件。LASSO和logistic回归分析将CIM与骨转移、铂治疗方案、化疗周期、化疗前中性粒细胞计数和药物组合等因素联系起来。在开发和验证队列中,模态图显示出较强的预测准确度,auc分别为0.886[95%置信区间(CI): 0.836-0.937]和0.905 (95% CI: 0.834-0.976),校准曲线一致性较高。DCA证实了它们的临床应用。结论:本研究开发了一个经过验证的nomogram,可以准确预测TNBC患者发生CIM的风险,帮助医疗保健提供者制定个性化的治疗计划。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
252
期刊介绍: Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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