A multivariable normal tissue complication probability model for predicting radiation-induced hypothyroidism in nasopharyngeal carcinoma patients in the modern radiotherapy era

Siriporn Wongwattananard, Anussara Prayongrat, Natchalee Srimaneekarn, Anthony Hayter, Jiratchaya Sophonphan, Seksan Kiatsupaibul, Puvarith Veerabulyarith, Yothin Rakvongthai, Napat Ritlumlert, Sarin Kitpanit, Danita Kannarunimit, Chawalit Lertbutsayanukul, Chakkapong Chakkabat

Research output: Contribution to journalArticlepeer-review

Abstract

Radiation-induced hypothyroidism (RHT) is a common long-term complication for nasopharyngeal carcinoma (NPC) survivors. A model using clinical and dosimetric factors for predicting risk of RHT could suggest a proper dose–volume parameters for the treatment planning in an individual level. We aim to develop a multivariable normal tissue complication probability (NTCP) model for RHT in NPC patients after intensity-modulated radiotherapy or volumetric modulated arc therapy. The model was developed using retrospective clinical data and dose–volume data of the thyroid and pituitary gland based on a standard backward stepwise multivariable logistic regression analysis and was then internally validated using 10-fold cross-validation. The final NTCP model consisted of age, pretreatment thyroid-stimulating hormone and mean thyroid dose. The model performance was good with an area under the receiver operating characteristic curve of 0.749 on an internal (200 patients) and 0.812 on an external (25 patients) validation. The mean thyroid dose at ≤45 Gy was suggested for treatment plan, owing to an RHT incidence of 2% versus 61% in the >45 Gy group.

Original languageEnglish
Pages (from-to)119-126
Number of pages8
JournalJournal of Radiation Research
Volume65
Issue number1
DOIs
Publication statusPublished - 1 Jan 2024

Keywords

  • nasopharyngeal carcinoma
  • normal tissue complication probability
  • predictive model
  • radiation-induced hypothyroidism
  • radiotherapy

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