Acute hematologic toxicity of radiation therapy - a comprehensive analysis and predictive nomogram.

IF 1.9 4区 医学 Q2 BIOLOGY
Kazuya Takeda, Rei Umezawa, Takaya Yamamoto, Noriyoshi Takahashi, Yu Suzuki, Keita Kishida, So Omata, Keiichi Jingu
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Abstract

To investigate radiation-induced cytopenia and establish predictive nomograms for hematological toxicity, we reviewed 3786 patients aged 18 or older who received radiation monotherapy between 2010 and 2021 for non-hematologic malignancies. We collected data on patient background, treatment content and hematologic toxicities for 12 weeks after the start of radiotherapy. The patients were randomly divided into training and test groups in 7:3 ratio. In the training group, we conducted ordered logistic regression analysis to identify predictive factors for neutropenia, lymphocytopenia, anemia and thrombocytopenia. Nomograms to predict Grade 2-4 cytopenia were generated and validated in the test group. Grade 3 or higher hematologic toxicities were observed in 9.7, 44.6, 8.3 and 3.1% of patients with neutropenia, lymphocytopenia, anemia and thrombocytopenia, respectively. We identified six factors for neutropenia grade, nine for lymphocytopenia grade and six for anemia grade with statistical significance. In the analysis of thrombocytopenia, the statistical model did not converge because of a small number of events. Nomograms were generated using factors with high predictive power. In evaluating the nomograms, we found high area under the receiver operating characteristic curve values (neutropenia; 0.75-0.85, lymphopenia; 0.89-0.91 and anemia; 0.85-0.86) in predicting Grade 2-4 cytopenia in the test group. We established predictive nomograms for neutropenia, leukocytopenia and anemia and demonstrated high reproducibility when validated in an independent cohort of patients.

放射治疗的急性血液学毒性——综合分析和预测列线图。
为了研究辐射诱导的细胞减少症并建立血液毒性的预测列线图,我们回顾了2010年至2021年间接受非血液系统恶性肿瘤放射单一治疗的3786名18岁或以上患者。我们收集了放射治疗开始后12周的患者背景、治疗内容和血液学毒性的数据。将患者按7:3的比例随机分为训练组和试验组。在训练组中,我们进行了有序逻辑回归分析,以确定中性粒细胞减少症、淋巴细胞减少症、贫血和血小板减少症的预测因素。在试验组中生成并验证了预测2-4级细胞减少的诺模图。中性粒细胞减少症、淋巴细胞减少症、贫血和血小板减少症患者分别有9.7%、44.6%、8.3%和3.1%出现3级或更高的血液毒性。我们确定了6个中性粒细胞减少症分级的因素,9个淋巴细胞减少症分级和6个贫血分级的因素具有统计学意义。在血小板减少症的分析中,由于事件数量较少,统计模型没有收敛。使用具有高预测能力的因素生成诺模图。在评估列线图时,我们发现受试者操作特征曲线下的高面积值(中性粒细胞减少症;0.75-0.85,淋巴细胞减少症;0.89-0.91和贫血;0.85-0.86)可预测试验组2-4级细胞减少症。我们建立了中性粒细胞减少症、白细胞减少症和贫血的预测列线图,并在独立的患者队列中进行验证时证明了高再现性。
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来源期刊
CiteScore
3.60
自引率
5.00%
发文量
86
审稿时长
4-8 weeks
期刊介绍: The Journal of Radiation Research (JRR) is an official journal of The Japanese Radiation Research Society (JRRS), and the Japanese Society for Radiation Oncology (JASTRO). Since its launch in 1960 as the official journal of the JRRS, the journal has published scientific articles in radiation science in biology, chemistry, physics, epidemiology, and environmental sciences. JRR broadened its scope to include oncology in 2009, when JASTRO partnered with the JRRS to publish the journal. Articles considered fall into two broad categories: Oncology & Medicine - including all aspects of research with patients that impacts on the treatment of cancer using radiation. Papers which cover related radiation therapies, radiation dosimetry, and those describing the basis for treatment methods including techniques, are also welcomed. Clinical case reports are not acceptable. Radiation Research - basic science studies of radiation effects on livings in the area of physics, chemistry, biology, epidemiology and environmental sciences. Please be advised that JRR does not accept any papers of pure physics or chemistry. The journal is bimonthly, and is edited and published by the JRR Editorial Committee.
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