Risk factors and predictive model for severe myelosuppression due to concurrent chemoradiotherapy in advanced cervical cancer

YE Haizhu; WANG Jie; PENG Xiaobao; KONG Ping

doi:10.3969/j.issn.1009-0460.2025.01.009

Abstract：Objective To investigate the risk factors for severe myelosuppression in patients with advanced cervical cancer undergoing concurrent chemoradiotherapy and further construct and validate a predictive model.Methods The clinical data of 112 patients with advanced cervical cancer who underwent concurrent chemoradiotherapy from July 2016 to March 2024 were retrospectively reviewed.Paitents were diveided into severe myelosuppression group(n=43)and non severe myelosuppression group(n=69).Logistic regression analysis was used to screen risk factors of severe myelosuppression.These factors were used to construct a nomogram prediction model and validate the discrimination,calibration and clinical utility of the model.Results The incidence of severe myelosuppression was 38.4%(43/112)among 112 cervical cancer patients.Age,BMI,chemotherapy regimen,radiation field,pre-treatment hemoglobin count and pre-treatment white blood cell count were related to severe myelosuppression(P<0.05).Multivariate logistic regression showed that age,BMI,chemotherapy regimen,pre-treatment hemoglobin count and pre-treatment white blood cell count were predictive factors for severe myelosuppression(P<0.05).R software was used to construct a nomogram model,and ROC curve showed that the AUC of the model was 0.907,significantly better than that of a single model,which indicated high prediction accuracy of the model.The calibration curve was close to the ideal curve,indicating that the model had good calibration ability.The decision curve(DCA)indicated that the model had good clinical net benefits and clinical practicality.Conclusion A nomogram model is successfully constructed,which has good predictive performance.It has important reference value for clinical physicians to predict whether severe myelosuppression will occur in patients with advanced cervical cancer undergoing concurrent chemoradiotherapy.