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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Hypothyroidism after primary radiotherapy for head and neck squamous cell carcinoma: Normal tissue complication probability modeling with latent time correction
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Hypothyroidism after primary radiotherapy for head and neck squamous cell carcinoma: Normal tissue complication probability modeling with latent time correction

机译：头颈部鳞状细胞癌原发放疗后的甲状腺功能减退：正常组织并发症概率建模与潜伏期校正

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Background and purpose To develop a normal tissue complication probability (NTCP) model of radiation-induced biochemical hypothyroidism (HT) after primary radiotherapy for head and neck squamous cell carcinoma (HNSCC) with adjustment for latency and clinical risk factors. Patients and methods Patients with HNSCC receiving definitive radiotherapy with 66-68 Gy without surgery were followed up with serial post-treatment thyrotropin (TSH) assessment. HT was defined as TSH 4.0 mU/l. Data were analyzed with both a logistic and a mixture model (correcting for latency) to determine risk factors for HT and develop an NTCP model based on mean thyroid dose (MTD) and thyroid volume. Results 203 patients were included. Median follow-up: 25.1 months. Five-year estimated risk of HT was 25.6%. In the mixture model, the only independent risk factors for HT were thyroid volume (cm3) (OR = 0.75 [95% CI: 0.64-0.85], p 0.001) and MTD (Gy) (OR = 1.12 [95% CI: 1.07-1.20], p 0.001). From the mixture NTCP-model individual dose constraints for a 25% risk of HT were 26, 38, 48 and 61 Gy for thyroid volumes of 10, 15, 20 and 25 cm3, respectively. Conclusions Comparing the logistic and mixture models demonstrates the importance of latent-time correction in NTCP-modeling. Thyroid dose constraints in treatment planning should be individualized based on thyroid volume.
机译：背景与目的建立头颈部鳞状细胞癌（HNSCC）初次放疗后放射诱发生化甲状腺功能减退（HT）的正常组织并发症概率（NTCP）模型，并调整潜伏期和临床危险因素。患者和方法对未经手术接受66-68 Gy明确放疗的HNSCC患者，进行连续治疗后促甲状腺激素（TSH）评估。 HT定义为TSH＞ 4.0mU / l。使用逻辑模型和混合模型（校正潜伏期）对数据进行分析，以确定HT的危险因素，并根据平均甲状腺剂量（MTD）和甲状腺体积建立NTCP模型。结果纳入203例患者。随访中位数：25.1个月。五年估计的HT风险为25.6％。在混合模型中，HT的唯一独立危险因素是甲状腺体积（cm3）（OR = 0.75 [95％CI：0.64-0.85]，p <0.001）和MTD（Gy）（OR = 1.12 [95％CI： 1.07-1.20]，p ＜0.001）。从混合物的NTCP模型中，对于10、15、20和25 cm3的甲状腺，分别有25％HT风险的个体剂量限制分别为26、38、48和61 Gy。结论比较逻辑模型和混合模型可以证明潜在时间校正在NTCP建模中的重要性。治疗计划中的甲状腺剂量限制应根据甲状腺容量进行个体化。

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