Nomogram for radiation-induced hypothyroidism prediction in nasopharyngeal carcinoma after treatment

作者：Ren Luo, Mei Li, Zhining Yang, Yizhou Zhan, Bao-Tian Huang, Jia-Yang Lu, Zhen-Xi Xu, Zhixiong Lin · 发表于：British Journal of Radiology · 年份：2016 · DOI：10.1259/bjr.20160686 · 被引用次数：28 · 研究领域：Head and Neck Cancer Studies、Thyroid Disorders and Treatments、Thyroid Cancer Diagnosis and Treatment

Objective: The aim of this study was to develop a nomogram for radiation-induced hypothyroidism (RHT) prediction. Methods: We collected data from 164 patients with nasopharyngeal carcinoma (NPC) in our previous prospective study. Biochemical hypothyroidism was defined as a serum thyroid-stimulating hormone level greater than the normal value. We collected both clinical and dose–volume factors. A univariate Cox regression analysis was performed to identify RHT risk factors. Optimal predictors were selected according to the least absolute shrinkage and selection operator (LASSO). We then selected the Cox regression models that best balanced the prediction performance and practicability to build a nomogram for RHT prediction. Results: There were 38 (23.2%) patients who developed RHT, and the median follow-up was 24 months. The univariate Cox regression analysis indicated that gender, minimum dose, mean dose (D mean) and V 25–V 60 [V x (%), the percentage of thyroid volume receiving >x Gy] of the thyroid were significantly associated with RHT. The variables of gender, receiving chemotherapy or not (chemo), D mean and V 50 were selected using the LASSO analysis. A nomogram based on a three-variable (gender, chemo and V 50) Cox regression model was constructed, and its concordance index was 0.72. Good accordance between prediction and observation was showed by calibration curves in the probability of RHT at 18, 24 and 30 months. Conclusion: This study built a nomogram for RH...