Incorporating axillary-lateral thoracic vessel juncture dosimetric variables improves model for predicting lymphedema in patients with breast cancer: A validation analysis.
| Autor: | Suk Chang J; Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea., Ko H; College of Medicine, The Catholic University of Korea, Republic of Korea., Hee Im S; Department and Research Institute of Rehabilitation Medicine, Severance Hospital, Yonsei University College of Medicine, Republic of Korea., Sung Kim J; Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea., Kyung Byun H; Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea., Bae Kim Y; Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea., Jung W; Department of Radiation Oncology, Ewha Womans University College of Medicine, Republic of Korea., Park G; Biostatistics Collaboration Unit, Yonsei University College of Medicine, Republic of Korea., Sun Lee H; Biostatistics Collaboration Unit, Yonsei University College of Medicine, Republic of Korea., Sung W; Department of Biomedical Engineering and of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Olson R; British Columbia Cancer Agency - Centre for the North, Prince George, BC, Canada., Hong CS; Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Republic of Korea., Kim K; Department of Radiation Oncology, Ewha Womans University College of Medicine, Republic of Korea. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2023 Apr 20; Vol. 41, pp. 100629. Date of Electronic Publication: 2023 Apr 20 (Print Publication: 2023). |
| DOI: | 10.1016/j.ctro.2023.100629 |
| Abstrakt: | Background: A relationship between the axillary-lateral thoracic vessel juncture (ALTJ) dose and lymphedema rate has been reported in patients with breast cancer. The purpose of this study was to validate this relationship and explore whether incorporation of the ALTJ dose-distribution parameters improves the prediction model's accuracy. Methods: A total of 1,449 women with breast cancer who were treated with multimodal therapies from two institutions were analyzed. We categorized regional nodal irradiation (RNI) as limited RNI, which excluded level I/II, vs extensive RNI, which included level I/II. The ALTJ was delineated retrospectively, and dosimetric and clinical parameters were analyzed to determine the accuracy of predicting the development of lymphedema. Decision tree and random forest algorithms were used to construct the prediction models of the obtained dataset. We used Harrell's C-index to assess discrimination. Results: The median follow-up time was 77.3 months, and the 5-year lymphedema rate was 6.8 %. According to the decision tree analysis, the lowest lymphedema rate (5-year, 1.2 %) was observed in patients with ≤ six removed lymph nodes and ≤ 66 % ALTJ V Conclusion: The prognostic value of ALTJ for lymphedema was externally validated. The estimation of lymphedema risk based on individual dose-distribution parameters of the ALTJ seemed more reliable than that based on the conventional RNI field design. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Author(s).) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|