Wu Lijun, Li Wen, Ma Xuanxuan, Yuan Mengmeng, Wang Yichun, Li Shuwen
School of Nursing, Anhui Medical University, Hefei, Anhui 230022, P.R. China.
Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China.
Oncol Lett. 2024 Oct 9;28(6):597. doi: 10.3892/ol.2024.14730. eCollection 2024 Dec.
Acute radiation esophagitis (ARE) is a common complication in patients with esophageal cancer undergoing radiotherapy. Therefore, it is important to construct an effective ARE risk-prediction model for clinical treatment. The present study performed a retrospective analysis of 225 patients with esophageal cancer who received radiotherapy at the First Affiliated Hospital of Anhui Medical University (Hefei, China) from January 2018 to December 2022. Univariate and logistic regression analyses were performed to screen patients with esophageal cancer after radiotherapy. The results revealed that 147 patients developed radiation esophagitis. Logistic regression analysis results demonstrated that the prognostic nutritional index [odds ratio (OR), 0.864; 95% confidence interval (CI), 0.809-0.924], neutrophil to lymphocyte ratio (OR, 1.795; 95% CI, 1.209-2.667) and platelet to lymphocyte ratio (OR, 1.011; 95% CI, 1.000-1.022) were independent predictors of ARE in patients receiving intensity-modulated conformal radiotherapy for esophagus cancer (P<0.05). A nomogram model for predicting the occurrence of ARE was established based on the three risk factors. The decision curve suggested a high net benefit value when the threshold probability was within 0.25-1.0. External verification confirmed the reproducibility and generalizability of the nomogram model. In general, the calibration curve of this model was close to the ideal curve and had excellent prediction accuracy. Therefore, it may be used as a new tool for early prediction of the ARE risk.
急性放射性食管炎(ARE)是接受放疗的食管癌患者常见的并发症。因此,构建有效的ARE风险预测模型对临床治疗具有重要意义。本研究对2018年1月至2022年12月在安徽医科大学第一附属医院(中国合肥)接受放疗的225例食管癌患者进行了回顾性分析。采用单因素和逻辑回归分析筛选食管癌放疗后的患者。结果显示,147例患者发生放射性食管炎。逻辑回归分析结果表明,预后营养指数[比值比(OR),0.864;95%置信区间(CI),0.809 - 0.924]、中性粒细胞与淋巴细胞比值(OR,1.795;95%CI,1.209 - 2.667)和血小板与淋巴细胞比值(OR,1.011;95%CI,1.000 - 1.022)是接受食管癌调强适形放疗患者ARE的独立预测因素(P<0.05)。基于这三个危险因素建立了预测ARE发生的列线图模型。决策曲线表明,当阈值概率在0.25 - 1.0范围内时,净效益值较高。外部验证证实了列线图模型的可重复性和可推广性。总体而言,该模型的校准曲线接近理想曲线,具有良好的预测准确性。因此,它可作为早期预测ARE风险的新工具。