2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-EP02.15

EP02.15 - Kang Wang

Pdf Summary

This study aims to create a predictive model for radiation esophagitis (RE) in non-small cell lung cancer (NSCLC) patients who are undergoing combined immunotherapy and thoracic radiotherapy (TRT). Conducted by researchers at Shandong Cancer Hospital and Institute, the study involved 102 NSCLC patients treated with immune checkpoint inhibitors (ICIs) and TRT between April 2021 and September 2023. The patients were split into a training cohort of 71 individuals and a validation cohort of 31.<br /><br />To build the predictive model, the researchers examined clinicopathologic features, dosimetric parameters, and inflammatory indicators via univariate logistic regression analysis. Significant factors identified were further analyzed in a multifactorial logistic regression, leading to the development of the nomogram. The independent predictors of radiation esophagitis included a time interval of fewer than nine days between the final immunotherapy session and radiotherapy, a maximum esophageal dose of more than 58.4 Gy, a mean esophageal dose exceeding 13.3 Gy, and various radiomic features.<br /><br />The model's effectiveness was analyzed using the receiver operating characteristic (ROC) curve, showing an area under the curve (AUC) of 0.807 in the training cohort and 0.794 in the validation cohort, suggesting good discriminative capability. Calibration curves indicated high agreement between predicted and observed RE occurrences, and decision curve analysis demonstrated significant positive net benefits, highlighting its potential clinical utility.<br /><br />In conclusion, the study successfully developed a validated nomogram that utilizes radiomic and dosimetric parameters combined with clinicopathological data to predict the occurrence of radiation esophagitis. This tool could significantly aid clinicians in managing and mitigating the risks associated with combined ICI and TRT therapy in NSCLC patients.

Keywords

predictive model

radiation esophagitis

non-small cell lung cancer

immunotherapy

thoracic radiotherapy

nomogram

clinicopathologic features

dosimetric parameters

radiomic features

Shandong Cancer Hospital