Independent validation of a dysphagia dose response model for the selection of head and neck cancer patients to proton therapy.
Journal
Physics and imaging in radiation oncology
ISSN: 2405-6316
Titre abrégé: Phys Imaging Radiat Oncol
Pays: Netherlands
ID NLM: 101704276
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
27
05
2022
revised:
09
09
2022
accepted:
09
09
2022
entrez:
26
9
2022
pubmed:
27
9
2022
medline:
27
9
2022
Statut:
epublish
Résumé
The model based approach involves the use of normal tissue complication models for selection of head and neck cancer patients to proton therapy. Our goal was to validate the clinical utility of the related dysphagia model using an independent patient cohort. A dataset of 277 head and neck cancer (pharynx and larynx) patients treated with (chemo)radiotherapy between 2019 and 2021 was acquired. For the evaluation of the model discrimination we used statistical metrics such as the sensitivity, specificity and the area under the receiver operating characteristic curve. After the validation we evaluated if the dysphagia model can be improved using the closed testing procedure, the Brier and the Hosmer-Lemeshow score. The performance of the original normal tissue complication probability model for dysphagia grade II-IV at 6 months was good (AUC = 0.80). According to the graphical calibration assessment, the original model showed underestimated dysphagia risk predictions. The closed testing procedure indicated that the model had to be updated and selected a revised model with new predictor coefficients as an optimal model. The revised model had also satisfactory discrimination (AUC = 0.83) with improved calibration. The validation of the normal tissue complication probability model for grade II-IV dysphagia was successful in our independent validation cohort. However, the closed testing procedure indicated that the model should be updated with new coefficients.
Sections du résumé
Background and purpose
UNASSIGNED
The model based approach involves the use of normal tissue complication models for selection of head and neck cancer patients to proton therapy. Our goal was to validate the clinical utility of the related dysphagia model using an independent patient cohort.
Materials and Methods
UNASSIGNED
A dataset of 277 head and neck cancer (pharynx and larynx) patients treated with (chemo)radiotherapy between 2019 and 2021 was acquired. For the evaluation of the model discrimination we used statistical metrics such as the sensitivity, specificity and the area under the receiver operating characteristic curve. After the validation we evaluated if the dysphagia model can be improved using the closed testing procedure, the Brier and the Hosmer-Lemeshow score.
Results
UNASSIGNED
The performance of the original normal tissue complication probability model for dysphagia grade II-IV at 6 months was good (AUC = 0.80). According to the graphical calibration assessment, the original model showed underestimated dysphagia risk predictions. The closed testing procedure indicated that the model had to be updated and selected a revised model with new predictor coefficients as an optimal model. The revised model had also satisfactory discrimination (AUC = 0.83) with improved calibration.
Conclusion
UNASSIGNED
The validation of the normal tissue complication probability model for grade II-IV dysphagia was successful in our independent validation cohort. However, the closed testing procedure indicated that the model should be updated with new coefficients.
Identifiants
pubmed: 36158240
doi: 10.1016/j.phro.2022.09.005
pii: S2405-6316(22)00081-1
pmc: PMC9493379
doi:
Types de publication
Journal Article
Langues
eng
Pagination
47-52Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Prof. Dr. Andre Dekker and Dr. Johan Van Soest are founders and stock owners of Medical Data Works B.V. which has products that are related to knowledge graphs. Prof. Dr. Johannes Langedijk has a research agreement between the Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen. The Netherlands and the companies IBA and RaySearch. Furthermore, Prof. Dr. Johannes Langedijk is a member of the Global Advisory Board of the company IBA for the research and development of the company. Moreover, Prof. Dr. Johannes Langedijk is a member of the RayCare Clinical Advisory Board of the company RaySearch as he provides advices on the development of RayCare. Dr. Rianne Fijten has received research funding from Varian Medical Systems. In addition, she is the chair of the Open Science Community Maastricht and a member of the Dutch Open Science Communities NL (OSC-NL) steering committee.
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