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宫颈癌放疗后阴道剂量与放射性阴道损伤的关系研究及模型构建

Study on the relationship between vaginal dose and radiation-induced vaginal injury following cervical cancer radiotherapy, and model development.

作者信息

Kong Fei, Yan Ziqin, Gao Liying, Long Jianping, Wang Xu, Zheng Zhangcai

机构信息

Gansu Provincial Maternal and Child Health Care Hospital (Gansu Provincial Central Hospital), Lanzhou, China.

Cloud Gansu Technology Co., Ltd., Lanzhou, China.

出版信息

Front Public Health. 2025 May 19;13:1585481. doi: 10.3389/fpubh.2025.1585481. eCollection 2025.

DOI:10.3389/fpubh.2025.1585481
PMID:40458090
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12128087/
Abstract

OBJECTIVE

This study investigates the relationship between vaginal radiation dose and radiation-induced vaginal injury in cervical cancer patients, with the aim of developing a risk prediction model to support personalized treatment strategies.

METHODS

A retrospective analysis was performed on the clinical data of 66 cervical cancer patients treated between December 2022 and December 2023. The Synthetic Minority Over-sampling Technique (SMOTE) was employed for data augmentation. Univariate and multivariate analyses were conducted to identify key factors influencing radiation-induced vaginal injury, and five distinct algorithms were applied to develop predictive models. The AUC/ROC metric was used to assess the performance of the models.

RESULTS

Univariate analysis revealed significant associations between the posterior-inferior border of the symphysis (PIBS) point dose and brachytherapy dose with radiation-induced vaginal injury ( < 0.05). Multivariate analysis confirmed PIBS point dose, brachytherapy dose, age, external beam radiation dose, and vaginal involvement as significant factors. A neural network algorithm was chosen to construct the radiation-induced vaginal injury model, which was subsequently developed into an online tool.

CONCLUSION

The developed predictive model can assess the risk of radiation-induced vaginal injury, thereby facilitating the development of individualized radiotherapy plans.

摘要

目的

本研究调查宫颈癌患者阴道放射剂量与放射性阴道损伤之间的关系，旨在建立一个风险预测模型以支持个性化治疗策略。

方法

对2022年12月至2023年12月期间接受治疗的66例宫颈癌患者的临床资料进行回顾性分析。采用合成少数过采样技术（SMOTE）进行数据增强。进行单因素和多因素分析以确定影响放射性阴道损伤的关键因素，并应用五种不同算法建立预测模型。使用AUC/ROC指标评估模型性能。

结果

单因素分析显示耻骨联合后下缘（PIBS）点剂量和近距离放疗剂量与放射性阴道损伤之间存在显著关联（<0.05）。多因素分析证实PIBS点剂量、近距离放疗剂量、年龄、外照射剂量和阴道受累是显著因素。选择神经网络算法构建放射性阴道损伤模型，随后将其开发成在线工具。

结论

所建立的预测模型可评估放射性阴道损伤风险，从而有助于制定个体化放疗计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/0346e9b6956b/fpubh-13-1585481-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/940f7cc5f4ac/fpubh-13-1585481-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/6bb7a883911f/fpubh-13-1585481-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/d7b7288a7172/fpubh-13-1585481-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/0346e9b6956b/fpubh-13-1585481-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/940f7cc5f4ac/fpubh-13-1585481-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/6bb7a883911f/fpubh-13-1585481-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/d7b7288a7172/fpubh-13-1585481-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69aa/12128087/0346e9b6956b/fpubh-13-1585481-g004.jpg

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本文引用的文献

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Curr Oncol. 2025 Jan 17;32(1):47. doi: 10.3390/curroncol32010047.
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The Clinical Course of the Late Toxicity of Definitive Radiotherapy in Cervical Cancer.宫颈癌根治性放疗晚期毒性的临床病程。
Medicina (Kaunas). 2024 Aug 21;60(8):1364. doi: 10.3390/medicina60081364.
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Cancer incidence and mortality in China, 2022.2022年中国癌症发病率与死亡率
J Natl Cancer Cent. 2024 Feb 2;4(1):47-53. doi: 10.1016/j.jncc.2024.01.006. eCollection 2024 Mar.
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Neural networks with ReLU powers need less depth.ReLU 激活函数的神经网络需要的深度更小。
Neural Netw. 2024 Apr;172:106073. doi: 10.1016/j.neunet.2023.12.027. Epub 2023 Dec 19.
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Effect of Lactobacillus delbrueckii subsp. lactis on vaginal radiotherapy for gynecological cancer.鼠李糖乳杆菌乳亚种对妇科癌症阴道放疗的影响。
Sci Rep. 2023 Jun 21;13(1):10105. doi: 10.1038/s41598-023-37241-7.
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Precancerous Cervical Lesion Among Adult Women With Human Immune Deficiency Virus on Anti Retroviral Therapy At Saint Peter Specialized Hospital, Ethiopia: A Hospital-Based Cross-Sectional Study.埃塞俄比亚圣彼得专科医院接受抗逆转录病毒治疗的成年女性艾滋病毒感染者的宫颈癌前病变：一项基于医院的横断面研究
Front Oncol. 2022 Jul 22;12:910915. doi: 10.3389/fonc.2022.910915. eCollection 2022.
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