Analysis of influencing factors and construction of risk prediction model for acute radiation-induced skin in-jury caused by hypofractionated radiotherapy after breast-conserving surgery

WANG Jian-ting; SHAO Rui-yu; WANG Jing

doi:10.3969/j.issn.1674-3806.2023.12.11

Abstract：Objective To analyze the influencing factors of acute radiation-induced skin injury caused by hypofractionated radiotherapy after breast-conserving surgery,and to construct its risk prediction model.Methods The clinical data of 170 patients with breast cancer who underwent breast-conserving surgery for breast cancer in Tangshan People's Hospital from October 2020 to September 2022 were selected,and the 170 patients were divided into model group(119 cases)and validation group(51 cases)according to a ratio of 7∶3.According to the occurrence of acute radiation-induced skin injury,the patients of the model group were further divided into injury group(89 cases)and non-injury group(30 cases).The clinical data were compared between the injury group and the non-injury group,and the risk factors were analyzed using multivariate logistic regression,and the risk prediction model was constructed using nomo-gram.Results The results of multivariate logistic regression analysis showed that body mass index(BMI)≥28 kg/m2,history of diabetes,T stage of tumor at T2,triple negative breast cancer,the form of radiotherapy being sequential tumor bed electron line supplement radiotherapy,higher CD4+T lymphocyte apoptosis rate and hemoglobin(Hb)level were independent risk factors for the patients with acute radiation-induced skin injury(P＜0.05).Based on these indi-cators,a nomogram risk prediction model was constructed.The results of receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for predicting the risk of acute radiation-induced skin injury was 0.942(95%CI:0.890-0.974)for the model group,with the sensitivity of 97.14%and the specificity of 86.24%,and AUC for predicting the risk of acute radiation-induced skin injury was 0.926(95%CI:0.880-0.966)for the val-idation group,with the sensitivity of 86.36%,and the specificity of 90.40%.Conclusion BMI,history of diabetes,T stage of tumor,triple negative breast cancer,the form of radiotherapy,CD4+T lymphocyte apoptosis rate and Hb level are the factors affecting acute radiation-induced skin injury caused by hypofractionated radiotherapy after breast-conserving surgery.The risk prediction model of nomogram constructed based on this basis has good clinical applica-tion value.