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Item Type Journal Article
Title External Validation of a Predictive Model for Acute Skin Radiation Toxicity in the REQUITE Breast Cohort
Creator Rattay et al.
Author Tim Rattay
Author Petra Seibold
Author Miguel E. Aguado-Barrera
Author Manuel Altabas
Author David Azria
Author Gillian C. Barnett
Author Renée Bultijnck
Author Jenny Chang-Claude
Author Ananya Choudhury
Author Charlotte E. Coles
Author Alison M. Dunning
Author Rebecca M. Elliott
Author Marie-Pierre Farcy Jacquet
Author Sara Gutiérrez-Enríquez
Author Kerstie Johnson
Author Anusha Müller
Author Giselle Post
Author Tiziana Rancati
Author Victoria Reyes
Author Barry S. Rosenstein
Author Dirk De Ruysscher
Author Maria C. de Santis
Author Elena Sperk
Author Hilary Stobart
Author R. Paul Symonds
Author Begoña Taboada-Valladares
Author Ana Vega
Author Liv Veldeman
Author Adam J. Webb
Author Catharine M. West
Author Riccardo Valdagni
Author Christopher J. Talbot
Abstract Background: Acute skin toxicity is a common and usually transient side-effect of breast radiotherapy although, if sufficiently severe, it can affect breast cosmesis, aftercare costs and the patient's quality-of-life. The aim of this study was to develop predictive models for acute skin toxicity using published risk factors and externally validate the models in patients recruited into the prospective multi-center REQUITE (validating pREdictive models and biomarkers of radiotherapy toxicity to reduce side-effects and improve QUalITy of lifE in cancer survivors) study. Methods: Patient and treatment-related risk factors significantly associated with acute breast radiation toxicity on multivariate analysis were identified in the literature. These predictors were used to develop risk models for acute erythema and acute desquamation (skin loss) in three Radiogenomics Consortium cohorts of patients treated by breast-conserving surgery and whole breast external beam radiotherapy (n = 2,031). The models were externally validated in the REQUITE breast cancer cohort (n = 2,057). Results: The final risk model for acute erythema included BMI, breast size, hypo-fractionation, boost, tamoxifen use and smoking status. This model was validated in REQUITE with moderate discrimination (AUC 0.65), calibration and agreement between predicted and observed toxicity (Brier score 0.17). The risk model for acute desquamation, excluding the predictor tamoxifen use, failed to validate in the REQUITE cohort. Conclusions: While most published prediction research in the field has focused on model development, this study reports successful external validation of a predictive model using clinical risk factors for acute erythema following radiotherapy after breast-conserving surgery. This model retained discriminatory power but will benefit from further re-calibration. A similar model to predict acute desquamation failed to validate in the REQUITE cohort. Future improvements and more accurate predictions are expected through the addition of genetic markers and application of other modeling and machine learning techniques.
Publication Frontiers in Oncology
Volume 10
Pages 575909
Date 2020
Journal Abbr Front Oncol
Language eng
DOI 10.3389/fonc.2020.575909
ISSN 2234-943X
Library Catalog PubMed
Extra PMID: 33216838 PMCID: PMC7664984
Tags breast cancer, Clinical Competence, early toxicity, prediction model, validation
Date Added 2023/11/23 - 12:48:30
Date Modified 2024/12/15 - 11:30:55
Notes and Attachments PubMed entry (Attachment)
Texte intégral (Attachment)


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