Prediction of gastrointestinal toxicity after external beam radiotherapy for localized prostate cancer
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Prediction of gastrointestinal toxicity after external beam radiotherapy for localized prostate cancer (180 visite)

D'Avino V, Palma G, Liuzzi R, Conson M, Doria F, Salvatore M, Pacelli R, Cella L

Radiat Oncol (ISSN: 1748-717x), 2015 Apr 8; 10(1): 80-80.



Tipo di articolo: Journal Article, Research Support, Non-U. S. Gov'T,

Impact factor: 2.466, Impact factor a 5 anni: 2.768

Url: http://www.scopus.com/inward/record.url?eid=2-s2.0-84928013703&partnerID=40&md5=f154e10fdfc188bbbbd807cba9911ab5

Parole chiave: Lkb Model, Multivariate Model, Ntcp, Radiation Induced Rectum Toxicity, Acute Toxicity, Adult, Aged, Area Under The Curve, Article, Bootstrapping, Cancer Localization, Cancer Patient, Cancer Radiotherapy, Computer Assisted Radiotherapy, Disease Severity, External Beam Radiotherapy, Follow Up, Gastrointestinal Toxicity, Histogram, Human, Lyman Kutcher Burman Normal Tissue Complication Probability Model, Major Clinical Study, Prediction, Predictive Value, Prostate, Prostate Cancer, Radiation Dose, Radiation Dose Fractionation, Radiation Injury, Rectum Injury, Scoring System, Statistical Model, Controlled Study, Intermethod Comparison, Lyman Kutcher Burman Model, Mathematical Model, Maximum Likelihood Method, Multivariate Logistic Regression Analysis, Receiver Operating Characteristic, Statistical Analysis, Gastrointestinal Diseases, Diagnosis, Etiology, Theoretical, Prostatic Neoplasms, Roc Curve, Radiation Injuries, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Intensity-Modulated, Adverse Effects,

Affiliazioni:

*** IBB - CNR ***
Institute of Biostructure and Bioimaging, National Council of Research (CNR), Naples, Italy. vittoria.davino@ibb.cnr.it.
Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples, Italy. m.conson@gmail.com.


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Background: Gastrointestinal (GI) toxicity is a common effect following radiation therapy (RT) for prostate cancer. Purpose of the present work is to compare two Normal Tissue Complication Probability (NTCP) modelling approaches for prediction of late radio-induced GI toxicity after prostate external beam radiotherapy. Methods: The study includes 84 prostate cancer patients evaluated for late rectal toxicity after 3D conformal radiotherapy. Median age was 72years (range 53-85). All patients received a total dose of 76Gy to the prostate gland with daily fractions of 2Gy. The acute and late radio-induced GI complications were classified according to the RTOG/EORTC scoring system. Rectum dose-volume histograms were extracted for Lyman-Kutcher-Burman (LKB) NTCP model fitting using Maximum Likelihood Estimation. The bootstrap method was employed to test the fit robustness. The area under the receiver operating characteristic curve (AUC) was used to evaluate the predictive power of the LKB and to compare it with a multivariate logistic NTCP model previously determined. Results: At a median follow-up of 36months, 42% (35/84) of patients experienced grade 1-2 (G1-2) acute GI events while 25% (21/84) of patients developed G1-2 late GI events. The best-estimate of fitting parameters for LKB NTCP model for mild\\\\\\\\moderate GI toxicity resulted to be: D <inf> 50 </inf>=87.3Gy, m=0.37 and n=0.10. Bootstrap result showed that the parameter fit was robust. The AUC values for the LKB and for the multivariate logistic models were 0.60 and 0.75, respectively. Conclusions: We derived the parameters of the LKB model for mild\\\\\\\\moderate GI toxicity prediction and we compared its performance with that of a data-driven multivariate model. Compared to LKB, the multivariate model confirmed a higher predictive power as showed by the AUC values. © D'Avino et al.; licensee BioMed Central.
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