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一大群儿童癌症长期幸存者中第二原发性恶性肿瘤发病率的预测。

Prediction of second malignant neoplasm incidence in a large cohort of long-term survivors of childhood cancers.

作者信息

Dinu Irina, Liu Yan, Leisenring Wendy, Mertens Ann C, Neglia Joseph P, Hammond Sue, Robison Leslie L, Yasui Yutaka

机构信息

Department of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Pediatr Blood Cancer. 2008 May;50(5):1026-31. doi: 10.1002/pbc.21306.

Abstract

BACKGROUND

The ability to predict adverse-event occurrences accurately in long-term survivors of childhood cancer is of high importance in late effects research, both clinically and methodologically.

PROCEDURE

This article considers a statistical prediction of future events in a cohort, taking second malignant neoplasm (SMN) incidence in a large cohort of long-term childhood cancer survivors as an example. The method consists of dividing the follow-up period of the cohort into two non-overlapping periods, using the first period as "training data," with which we model the patterns of SMN occurrences in the cohort, and the subsequent period as "testing data," with which we validate the model based on the training data. Future predictions are also applied beyond the testing-data period to calculate the SMN incidence of the cohort in the next five years for overall and specific types of SMNs.

RESULTS

The proposed statistical prediction is shown empirically to perform well with respect to the prediction accuracy. Overall, the models were able to predict the future second cancers rates very well, with exceptions of a few cancer types that had very small observed counts in the testing period.

CONCLUSIONS

Our proposed statistical method predicts future events in a cohort of long-term childhood cancer survivors and, as such, is a useful tool for late effects research on childhood cancer survivors.

摘要

背景

在儿童癌症长期幸存者中准确预测不良事件的发生,在晚期效应研究中,无论在临床还是方法学方面都具有高度重要性。

程序

本文以一大群儿童癌症长期幸存者中的第二原发性恶性肿瘤(SMN)发病率为例,考虑对队列中未来事件进行统计预测。该方法包括将队列的随访期分为两个不重叠的时期,将第一个时期用作“训练数据”,据此对队列中SMN的发生模式进行建模,将随后的时期用作“测试数据”,据此基于训练数据验证模型。还将未来预测应用于测试数据期之后,以计算整个队列以及特定类型SMN在未来五年中的发病率。

结果

经验证,所提出的统计预测在预测准确性方面表现良好。总体而言,这些模型能够很好地预测未来的第二癌症发生率,但在测试期观察病例数非常少的少数癌症类型除外。

结论

我们提出的统计方法可预测儿童癌症长期幸存者队列中的未来事件,因此是儿童癌症幸存者晚期效应研究的有用工具。

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