浙江医学2026，Vol.48Issue(6)：599-603,5.DOI:10.12056/j.issn.1006-2785.2026.48.6.2024-2774
乳腺癌放疗致慢性放射性皮肤损伤的危险因素分析及列线图模型构建
Risk factor analysis and nomogram model construction of chronic radiation injury of skin caused by breast cancer radiotherapy
摘要
Abstract
Objective To analyze the risk factors for developing chronic radiation-induced skin injury(CRIS)caused by radiotherapy for breast cancer and to construct nomogram prediction model.Methods A retrospective study was conducted on 860 patients who underwent radical mastectomy and received radiotherapy in the Department of Radiotherapy and Chemotherapy of Tangshan People's Hospital from April 2017 to April 2022.These patients were randomly divided into a training set of 602 cases and a validation set of 258 cases.The training set was further divided into a CRIS group of 104 cases and a non-CRIS group of 498 cases based on the occurrence of CRIS.Logistic regression analysis was used to identify the risk factors for developing CRIS,and a nomogram prediction model was constructed.Internal validation of the model was completed by evaluating the calibration curve and clinical decision curve.External validation was completed by assessing the model's ability to predict the occurrence of CRIS in both the training and validation sets.Results The patients in the CRIS group had older age,higher body mass index and chemotherapy history proportion,and larger tumor diameter than those in the non-CRIS group(all P＜0.05),while serum albumin level was lower(P＜0.05).Advanced age(OR=4.495,95％CI:1.146-6.934),high body mass index(OR=3.710,95％CI:1.048-5.395),low serum albumin level(OR=7.471,95％CI:1.935-13.275),history of chemotherapy(OR=6.025,95％CI:1.845-9.284),and relatively large tumor diameter(OR=8.306,95％CI:2.004-15.934)were all the independent risk factors for the occurrence of CRIS during breast cancer radiotherapy(all P＜0.05).Internal validation results showed that the nomogram prediction model had satisfactory discrimination and consistency,providing higher clinical net benefit than other independent predictors.External validation results indicated that the model's performance in predicting the occurrence of CRIS in the training and validation sets was essentially consistent.Conclusion Advanced age,high body mass index,low serum albumin level,history of chemotherapy,and large tumor diameter are all the independent risk factors for the occurrence of CRIS caused by radiotherapy in breast cancer.The risk nomogram prediction model for CRIS occurrence constructed based on these factors has certain application value for the prevention and treatment of this disease.关键词
乳腺癌/慢性放射性皮肤损伤/影响因素/列线图模型/预测Key words
Breast cancer/Chronic radiation injury of skin/Influencing factor/Nomogram model/Prediction引用本文复制引用
崔文韬,黄昱霖,迟子锋,苗明昌,杨海芳,田龙,陈璇..乳腺癌放疗致慢性放射性皮肤损伤的危险因素分析及列线图模型构建[J].浙江医学,2026,48(6):599-603,5.基金项目
河北省医学科学研究课题计划资助(20261069) （20261069）
