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头颈部肿瘤严重放射性口腔黏膜炎的危险因素及预测模型的建立。

Risk factor and prediction model development for severe radiation-induced oral mucositis in head and neck tumors.

机构信息

Otolaryngology & Head & Neck Center, Cancer Center, Department of Otolaryngology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.

Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China.

出版信息

Future Oncol. 2024;20(31):2385-2395. doi: 10.1080/14796694.2024.2384353. Epub 2024 Aug 6.

Abstract

This article aims to identify risk factors for severe radiation-induced oral mucositis (RIOM) in head and neck cancer (HNC) patients. In addition, we intend to establish a predictive model in patients undergoing intensity-modulated radiotherapy. In this retrospective study, several HNC patients (n = 179) treated at Zhejiang Provincial People's Hospital from January 2019 to June 2023 were considered. The recruited subjects were divided into modeling and validation groups. The experimental data on clinical characteristics and treatment were collected and analyzed to identify predictive factors for severe RIOM based on the logistic regression approach. The results indicated that severe RIOM occurred in 55.3% of patients. Accordingly, significant predictors included smoking history, diabetes, concurrent chemotherapy, cumulative radiation dose and weight loss of ≥5% in relative to admission weight. A nomogram based on these factors was validated, showing excellent predictive accuracy. In summary, the predictive model could effectively identify high-risk patients for severe RIOM, enabling the design of targeted interventions and improving patient management during radiotherapy.

摘要

本文旨在确定头颈部癌症(HNC)患者接受调强放疗后发生重度放射性口腔黏膜炎(RIOM)的危险因素,并建立预测模型。本回顾性研究纳入了 2019 年 1 月至 2023 年 6 月在浙江省人民医院治疗的 179 例 HNC 患者。将研究对象分为建模组和验证组。收集并分析了临床特征和治疗相关的实验数据,采用逻辑回归方法确定重度 RIOM 的预测因素。结果显示,55.3%的患者发生了重度 RIOM。有显著意义的预测因素包括吸烟史、糖尿病、同期化疗、累积辐射剂量和体重相对于入院时减轻≥5%。基于这些因素建立的列线图具有良好的预测准确性。总之,该预测模型可以有效识别重度 RIOM 的高危患者,有助于设计针对性的干预措施,并改善放疗期间患者的管理。

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