Normal tissue complication probability (NTCP) modelling using spatial dose metrics and machine learning methods for severe acute oral mucositis resulting from head and neck radiotherapy.
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Date
2016-07-01Author
Dean, JA
Wong, KH
Welsh, LC
Jones, A-B
Schick, U
Newbold, KL
Bhide, SA
Harrington, KJ
Nutting, CM
Gulliford, SL
Type
Journal Article
Metadata
Show full item recordAbstract
BACKGROUND AND PURPOSE: Severe acute mucositis commonly results from head and neck (chemo)radiotherapy. A predictive model of mucositis could guide clinical decision-making and inform treatment planning. We aimed to generate such a model using spatial dose metrics and machine learning. MATERIALS AND METHODS: Predictive models of severe acute mucositis were generated using radiotherapy dose (dose-volume and spatial dose metrics) and clinical data. Penalised logistic regression, support vector classification and random forest classification (RFC) models were generated and compared. Internal validation was performed (with 100-iteration cross-validation), using multiple metrics, including area under the receiver operating characteristic curve (AUC) and calibration slope, to assess performance. Associations between covariates and severe mucositis were explored using the models. RESULTS: The dose-volume-based models (standard) performed equally to those incorporating spatial information. Discrimination was similar between models, but the RFCstandard had the best calibration. The mean AUC and calibration slope for this model were 0.71 (s.d.=0.09) and 3.9 (s.d.=2.2), respectively. The volumes of oral cavity receiving intermediate and high doses were associated with severe mucositis. CONCLUSIONS: The RFCstandard model performance is modest-to-good, but should be improved, and requires external validation. Reducing the volumes of oral cavity receiving intermediate and high doses may reduce mucositis incidence.
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Subject
Humans
Head and Neck Neoplasms
Stomatitis
Radiation Injuries
Acute Disease
Radiotherapy Dosage
Logistic Models
Probability
Models, Theoretical
Female
Male
Machine Learning
Clinical Decision-Making
Research team
Clinical Academic Radiotherapy (Horwich)
Radiotherapy Physics Modelling
Targeted Therapy
Language
eng
Date accepted
2016-05-12
License start date
2016-07
Citation
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016, 120 (1), pp. 21 - 27
Publisher
ELSEVIER IRELAND LTD