肿瘤防治研究2026，Vol.53Issue(7)：534-541,8.DOI:10.3971/j.issn.1000-8578.2026.25.0880
基于CT影像组学构建宫颈癌单纯放疗后急性血液毒性的预测模型
Prediction Model of Acute Hematologic Toxicity in Patients with Cervical Cancer After Definitive Radiotherapy Based on CT Radiomics
摘要
Abstract
Objective To develop a predictive model of acute hematologic toxicity(HT)based on preradiotherapy CT radiomic features combined with clinical and dosimetric characteristics for patients with cervical cancer undergoing definitive radiotherapy.Methods Data from 82 patients with cervical cancer who received definitive radiotherapy were retrospectively analyzed.The patients were divided into training and test sets at an 8:2 ratio,with grade≥2 HT as the study endpoint.Clinical characteristics and dosimetric parameters of pelvic regions were collected,and 1 046 radiomic features were extracted from the overall pelvic structure using PyRadiomics.Radiomic features were processed using Z-score normalization,Spearman correlation analysis(>0.9),and LASSO regression for feature selection.A radiomics model was constructed using K-nearest neighbor machine learning with fivefold cross-validation.For 56 clinical and dosimetric features,independent predictors were identified through univariate and multivariate analyses to establish a clinical-dose model.A hybrid model was further constructed by combining the two sets of features.Model performance was evaluated using the area under the receiver operating characteristic curve(AUC),decision curve analysis,and calibration curves.Results Forty patients(48.8%)developed grade≥2 HT.Univariate and multivariate analyses showed that V20 of the lumbosacral spine was significantly associated with grade≥2 HT(P<0.05).The AUC values for the radiomics,clinical-dose,and hybrid models were 0.802,0.750,and 0.861 in the training set,respectively,and 0.703,0.633,and 0.781 in the test set,respectively.Conclusion Preradiotherapy CT radiomic features combined with dosimetric characteristics can predict the occurrence of acute hematologic toxicity in patients with cervical cancer,potentially facilitating early clinical intervention.关键词
宫颈癌/放射治疗/血液毒性/影像组学Key words
Cervical cancer/Radiation therapy/Hematologic toxicity/Radiomics分类
医药卫生引用本文复制引用
杨甜甜,孔燕,吴刚,吴佳,顾科..基于CT影像组学构建宫颈癌单纯放疗后急性血液毒性的预测模型[J].肿瘤防治研究,2026,53(7):534-541,8.基金项目
无锡市卫生健康委员会科研项目(重大项目)(Z202416)Scientific Research Project of Wuxi Municipal Health and Wellness Commission(No.Z202416) （重大项目）
