Department of Radiation Oncology Center, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
Am J Clin Oncol. 2024 Jul 1;47(7):317-324. doi: 10.1097/COC.0000000000001096. Epub 2024 Mar 15.
To analyze the risk factors for grade ≥2 ARE in patients with cervical cancer receiving concurrent chemoradiotherapy.
A total of 273 patients with cervical cancer receiving concurrent chemoradiotherapy at our hospital were retrospectively enrolled. The patients were divided into training and validation groups. Clinical parameters were analyzed using univariate analysis and multivariate logistic regression analysis. A nomogram model was established based on the independent risk factors selected using multivariate logistic regression. The areas under the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the nomogram. The patients were divided into low-score and high-score groups based on the scores calculated using the nomogram model and compared.
Malnutrition, monocyte-lymphocyte ratio ≥0.82 after radiotherapy, platelet-lymphocyte ratio <307.50 after radiotherapy, and bowelbag volume receiving at least 5 and 40 Gy were independent risk factors for grade ≥2 ARE and were incorporated into the nomogram ( P <0.05). The ROC curve, calibration curve, and DCA suggested that the nomogram had good discrimination, concordance, and net benefit in the clinical. A medium nomogram score of 146.50 points was used as the cutoff point, and the incidence of grade ≥2 ARE in the high-score group was higher than that in the low-score group ( P <0.05).
The nomogram model for grade ≥2 ARE has good predictive ability and clinical utility, and is convenient for clinicians to identify high-risk groups and develop early prevention and treatment strategies.
分析宫颈癌患者同步放化疗后发生≥2 级放射性肠炎（ARE）的危险因素。
回顾性分析我院收治的 273 例宫颈癌同步放化疗患者的临床资料。将患者分为训练组和验证组。采用单因素分析和多因素 logistic 回归分析对临床参数进行分析。基于多因素 logistic 回归筛选的独立危险因素建立列线图模型。采用受试者工作特征（ROC）曲线下面积、校准曲线和决策曲线分析（DCA）评估列线图。根据列线图模型计算的评分将患者分为低分组和高分组，并进行比较。
营养不良、放疗后单核细胞-淋巴细胞比值≥0.82、放疗后血小板-淋巴细胞比值<307.50、接受至少 5Gy 和 40Gy 的肠袋体积是发生≥2 级 ARE 的独立危险因素，并被纳入列线图（P<0.05）。ROC 曲线、校准曲线和 DCA 表明，该列线图在临床中具有良好的区分度、一致性和净收益。以中值列线图评分 146.50 分为截断点，高分组的≥2 级 ARE 发生率高于低分组（P<0.05）。
≥2 级 ARE 的列线图模型具有良好的预测能力和临床实用性，方便临床医生识别高危人群并制定早期预防和治疗策略。
