title: LASSO-based NTCP model for radiation-induced temporal lobe injury developing after intensity-modulated radiotherapy of nasopharyngeal carcinoma.
abstract: We investigated the incidence of temporal lobe injury (TLI) in 132 nasopharyngeal carcinoma (NPC) patients who had undergone intensity-modulated radiotherapy (IMRT) in our hospital between March 2005 and November 2009; and identified significant dosimetric predictors of TLI development. Contrast-enhanced lesions or cysts in the temporal lobes, as detected by magnetic resonance imaging (MRI), were regarded as radiation-induced TLIs. We used the least absolute shrinkage and selection operator (LASSO) method to select Dmax (the maximum point dose) and the D1cc (the top dose delivered to a 1-mL volume) from 15 dose-volume-histogram-associated and four clinically relevant candidate factors; the Dmax and the D1cc were the most significant predictors of TLI development. We drew dose-response curves for Dmax and D1cc. The tolerance dose (TD) for the 5% and 50% probabilities of TLI development were 69.0 ± 1.6 and 82.1 ± 2.4 Gy for Dmax and 62.8 ± 2.2 and 80.9 ± 3.4 Gy for D1cc, respectively. The incidence of TLI in NPC patients after IMRT was higher than expected because the therapeutic window is narrow. High-quality longitudinal studies are needed to gain further insight into the complex spatiotemporal effects of non-uniform irradiation on TLI development in NPC patients.
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Kong
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Xiang-Zhi
authors.initials: XZ
authors.lastname: Zhu
authors.affiliation: Medical Physics and Informatics Laboratory of Electronics Engineering, National Kaohsiung University of Applied Sciences, Kaohsiung, 80778 Taiwan, ROC.|Institute of Clinical Medicine, Kaohsiung Medical University, 807 Taiwan, ROC.
authors.forename: Tsair-Fwu
authors.initials: TF
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Ping-Bo
authors.initials: PB
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Xu
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Pu-Dong
authors.initials: PD
authors.lastname: Qian
authors.affiliation: Department of Radiology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Lan-Fang
authors.initials: LF
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Xia
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Sheng-Fu
authors.initials: SF
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Affiliated Hospital of Nanjing Medical University, and Cancer Center of Jiangsu Province, Nanjing, People's Republic of China.
authors.forename: Yi-Qin
authors.initials: YQ
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D002277:Carcinoma / Q000532:radiotherapy*; D002648:Child; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D011874:Radiometry; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000293:injuries* / Q000528:radiation effects; D016896:Treatment Outcome; D055815:Young Adult