| Fu Yi,Ma Chenying,Li Shuyue,et al.Prediction model of radiation enteritis under the total neoadjuvant therapy for locally advanced rectal cancer[J].Chinese Journal of Radiological Medicine and Protection,2025,45(8):757-765 |
| Prediction model of radiation enteritis under the total neoadjuvant therapy for locally advanced rectal cancer |
| Received:February 09, 2025 |
| DOI：10.3760/cma.j.cn112271-20250209-00046 |
| KeyWords:Rectal tumor Radiotherapy Acute radiation enteritis Nutritional indicators Total neoadjuvant therapy |
| FundProject:国家自然科学基金(81602792);江苏省高等学校基础科学(自然科学)研究面上项目(23KJB310023);江苏省妇幼保健科研项目(F202210);江苏省医学重点学科(ZDXK202235);放射医学与辐射防护国家重点实验室资助项目(GZK1202101);苏州市科技项目(SLT201920);苏州大学附属第一医院临床诊疗技术创新项目青年特色技术项目(2100201) |
| Author Name | Affiliation | E-mail | | Fu Yi | Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Ma Chenying | Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Li Shuyue | Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Chen Jie | Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Gan Guanghui | Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Zhou Juying | Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China | zhoujuyingsy@163.com |
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| Abstract:: |
| Objective To analyze relevant factors influencing severe acute radiation enteritis (SARE) during total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC). To identify specific prediction indicators of the occurrence and progression of radiation enteritis by investigating the effect relationships between radiation enteritis and multidimensional factors. Methods A total of 92 patients with rectal adenocarcinoma who received total neoadjuvant therapy at the First Affiliated Hospital of Soochow University from January 2020 to September 2023 were enrolled in this study. Their relevant information was collected, encompassing clinical nutritional indicators, dynamic changes in hematological parameters, systemic inflammatory indicators, and the occurrence of adverse reactions. Then, risk factors associated with radiation enteritis were determined using logistic regression analysis. Based on independent risk factors, a nomogram model for risk prediction was constructed. Results Univariate analysis revealed significant correlations of the SARE occurrence with certain nutritional indicators, local tumor measurement data, and laboratory parameters. Multivariate regression analysis further identified the independent risk factors for SARE occurrence, including albumin reduction >26.5% before vs. after treatment (OR = 5.010, 95% CI: 1.766-14.154, P = 0.010), rectual tenesmus rating of Grade 1-3 (OR = 3.639, 95%CI: 1.425-9.300, P = 0.024), and elevated disease activity index (DAI) score (OR ≈ 7.683 per 1-point increase, 95%CI: 1.105-53.410, P = 0.039). The prediction model constructed based on these factors demonstrated high prediction efficiency (AUC = 0.841; 95%CI: 0.749-0.934). Conclusions The nomogram model constructed using albumin reduction, rectal tenesmus rating, and DAI score can provide accurate, simple, and low-cost risk prediction of radiation enteritis during TNT for LARC patients. This model facilitates the early clinical identification of high-risk patients, providing a basis for implementing personalized adjustments to radiotherapy regimens and enhancing nutritional interventions. |
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