title: LASSO NTCP predictors for the incidence of xerostomia in patients with head and neck squamous cell carcinoma and nasopharyngeal carcinoma.
abstract: To predict the incidence of moderate-to-severe patient-reported xerostomia among head and neck squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT). Multivariable normal tissue complication probability (NTCP) models were developed by using quality of life questionnaire datasets from 152 patients with HNSCC and 84 patients with NPC. The primary endpoint was defined as moderate-to-severe xerostomia after IMRT. The numbers of predictive factors for a multivariable logistic regression model were determined using the least absolute shrinkage and selection operator (LASSO) with bootstrapping technique. Four predictive models were achieved by LASSO with the smallest number of factors while preserving predictive value with higher AUC performance. For all models, the dosimetric factors for the mean dose given to the contralateral and ipsilateral parotid gland were selected as the most significant predictors. Followed by the different clinical and socio-economic factors being selected, namely age, financial status, T stage, and education for different models were chosen. The predicted incidence of xerostomia for HNSCC and NPC patients can be improved by using multivariable logistic regression models with LASSO technique. The predictive model developed in HNSCC cannot be generalized to NPC cohort treated with IMRT without validation and vice versa.
authors.affiliation: Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, ROC.
authors.forename: Tsair-Fwu
authors.initials: TF
authors.lastname: Lee
authors.affiliation: 1] Department of Electrical Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, ROC [2] Department of Radiation Oncology, Kaohsiung Yuan's General Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Ming-Hsiang
authors.initials: MH
authors.lastname: Liou
authors.affiliation: Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Huang
authors.affiliation: 1] Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, ROC [2] Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Pei-Ju
authors.initials: PJ
authors.lastname: Chao
authors.affiliation: 1] Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, ROC [2] Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Ting
authors.affiliation: Department of Electrical Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, Taiwan, ROC.
authors.forename: Hsiao-Yi
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Fu-Min
authors.initials: FM
authors.lastname: Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011336:Probability; D011788:Quality of Life; D011832:Radiation Injuries / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014987:Xerostomia / Q000453:epidemiology*