Therapeutic Effect and Prediction Model Construction of Retroperitoneal Lymph Node Metastasis Treated with Cyberknife
WANG Yanling
ZHANG Yiping
GAO Yunhong
FENG Jing
Abstract：Objective To analyze the therapeutic effect of cyberknife on retroperitoneal lymph node metastasis,and establish a risk prediction model.Methods A total of 100 patients with retroperitoneal lymph node metastasis who received treatment in Zhengzhou Yihe Hospital from January 2018 to January 2024 were selected and all of them received cyberknife treatment.After 3 months of treatment,the clinical efficacy of the patients was evaluated,and the patients with complete response(CR)and partial response(PR)were included in the effective group,and the patients with stable disease(SD)and progression disease(PD)were included in the ineffective group.The clinical data of the two groups were compared,and logistic regression model was used to analyze the related factors affecting the efficacy of patients with retroperitoneal lymph node metastasis.The risk prediction model was constructed,and the calibration curve,Hosmer-Lemeshow test and receiver operating characteristic(ROC)curve were used to verify the efficiency of the model.Results One hundred patients with retroperitoneal lymph node metastasis were treated with cyberknife for 3 months.After follow-up,it was found that there were 7 cases(7.00％)of CR,56 cases(56.00％)of PR,28 cases(28.00％)of SD,and 9 cases(9.00％)of PD.The disease control rate(DCR)was 91.00％.The objective response rate(ORR)was 63.00％.There were no significant differences in gender,age,Karnofsky performance status(KPS),smoking history,drinking history,hypertension,diabetes mellitus and pathological types of primary lesions between effective and ineffective groups(P＞0.05).There were significant differences in tumor maximum diameter,bioequivalent dose,distance between tumor and intestinal tube between the two groups(P＜0.05).Multivariate logistic regression analysis showed that maximum tumor diameter,bioequivalent dose,and distance between tumor and bowel were independent influencing factors for efficacy in patients with retroperitoneal lymph node metastasis(P＜0.05).By constructing a risk prediction model,it was found that maximum tumor diameter was the strongest predictor of efficacy in patients with retroperitoneal lymph node metastases,followed by bioequivalent dose and distance between tumor and intestinal tube.Calibration curve results showed that there was a good consistency between the actual efficacy and prediction probability of patients with retroperitoneal lymph node metastasis,and the consistency index was 0.822,indicating high prediction accuracy.Hosmer-Lemeshow test showed that there was no significant difference between the predicted value and the true value of the risk prediction model(x2=1.362,P=0.318),indicating that the model had a good fit and high prediction accuracy.ROC curve showed that the area under the curve(AUC)of risk prediction model to predict the efficacy of retroperitoneal lymph node metastasis patients was 0.832(95％CI:0.747-0.922),sensitivity was 0.825,specificity was 0.762,and Yodon index was 0.587,suggesting that the risk prediction model was moderately differentiated and had good prediction efficacy.Conclusion Cyberknife treatment of retroperitoneal lymph node metastasis has a good effect,and the maximum diameter of the tumor,bioequivalent dose,and the distance between the tumor and intestinal tube are independent factors affecting the curative effect of patients.In addition,through the construction of risk prediction model,it is beneficial to identify high-risk groups early so as to take timely intervention measures.
Keywords：retroperitoneal lymph node metastasescyberknifecurative effectrisk prediction model
Publication Date：2025-11-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 4085-4089 )