Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, People's Republic of China.
Clin Transl Oncol. 2013 May;15(5):364-9. doi: 10.1007/s12094-012-0931-y. Epub 2012 Sep 14.
To assess the predictability of dose-volume histogram (DVH) parameters for radiation pneumonitis (RP) using receiver operating characteristic (ROC) curve.
One hundred and thirty-five cases of locally advanced non-small cell lung cancer patients treated with three-dimensional radiotherapy and chemotherapy were analyzed retrospectively. The end point of follow-up was ≥2 grade RP defined according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3.0. The ROC curve was used to explore the predictive sensitivity (SEN), specificity (SPE), positive predictive value (PPV), and negative predictive value (NPV) for potential DVH parameters associated with RP.
Relative volumes of total lungs receiving ≥5 Gy (V(5)), ≥10 Gy (V(10)), ≥13 Gy (V(13)), ≥20 Gy (V(20)), and mean lung dose (MLD), were all correlated to the development of RP (p < 0.05), among which V 5 and V 20 were the most important factors (p = 0.045 and 0.037; OR = 3.166 and 3.030). However, collinearity was found between V(5) and V(20) (Spearman's rho 0.771, p < 0.01). The area under the ROC curve was 0.643 and 0.648 for using V(5) and V(20) as predictors. If predictive cut-off values were established as follows: V(5) = 0.8 and V(20) = 0.3, the parameters could provide predictive SEN, SPE, PPV and NPV were 0.387 and 0.581, 0.882 and 0.701, 0.444 and 0.321, and 0.855 and 0.873, respectively.
V(5) and V(20) could act as predictors for RP; however, single DVH metrics did not appear to have high predictive power for RP.
利用受试者工作特征（ROC）曲线评估剂量-体积直方图（DVH）参数预测放射性肺炎（RP）的能力。
回顾性分析 135 例接受三维适形放疗和化疗的局部晚期非小细胞肺癌患者。随访终点为根据美国国立癌症研究所不良事件通用术语标准，版本 3.0 定义的≥2 级 RP。ROC 曲线用于探讨与 RP 相关的潜在 DVH 参数的预测敏感性（SEN）、特异性（SPE）、阳性预测值（PPV）和阴性预测值（NPV）。
全肺接受≥5 Gy（V（5））、≥10 Gy（V（10））、≥13 Gy（V（13））、≥20 Gy（V（20））和平均肺剂量（MLD）的相对体积均与 RP 的发生相关（p<0.05），其中 V5 和 V20 是最重要的因素（p=0.045 和 0.037；OR=3.166 和 3.030）。然而，V（5）和 V（20）之间存在共线性（Spearman's rho 0.771，p<0.01）。使用 V（5）和 V（20）作为预测因子时，ROC 曲线下面积分别为 0.643 和 0.648。如果预测截断值设定为：V（5）=0.8，V（20）=0.3，则这些参数的预测 SEN、SPE、PPV 和 NPV 分别为 0.387 和 0.581、0.882 和 0.701、0.444 和 0.321、0.855 和 0.873。
V（5）和 V（20）可以作为 RP 的预测因子；然而，单一的 DVH 指标似乎对 RP 没有很高的预测能力。
