Objective To establish a Nomogram model for predicting acute radiation dermatitis (ARD) caused by intensity modulated radiotherapy for esophageal cancer and verify its predictive ability.
Methods A total of 179 thoracic esophageal cancer patients with intensity modulated radiation therapy were selected as the research objects, and they were divided into ≥ grade 3 ARD group and control group according to the incidence of ARD grade 3 or above. The predictors of ≥ grade 3 ARD caused by intensity modulated radiation therapy for esophageal cancer were screened by univariate, LASSO regression and multivariate Logistic regression analyses, and the Nomogram model was established.
Results Diabetes, albumin level < 30 g/L, Karnofsky score < 80, radiation dose ≥ 65 Gy and concurrent chemotherapy were the independent risk factors of ≥ grade 3 ARD caused by intensity modulated radiation therapy for esophageal cancer (P < 0.05). The model verification results showed that the consistency index (C-index) was 0.771, and the calibration curve was close to the ideal curve; the area under the curve (AUC) of receiver operating characteristic (ROC) curve was 0.778 (95%CI, 0.738 to 0.818), and the net benefit of the model was in the prediction range of 12% to 64%, indicating that the Nomogram model had good prediction ability.
Conclusion The risk factors of ≥ grade 3 ARD caused by intensity modulated radiation therapy for esophageal cancer include diabetes, albumin level < 30 g/L, Karnofsky score < 80, radiotherapy dose ≥ 65 Gy and concurrent chemotherapy, and the Nomogram model based on risk factors has good predictive ability.
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