Establishment and Verification of A Model for Predicting the Efficacy of Radiotherapy and Chemotherapy in Triple Negative Breast Cancer Patients

REN Hongyuan; LI Chunrui; DU Rui

doi:10.3639/j.issn.2095-3097.2025.06.003

Abstract：Objective To analyze the factors influencing the efficacy of radiotherapy and chemotherapy in patients with triple-negative breast cancer and to build a nomogram prediction model.Methods A total of 260 patients with triple-negative breast cancer admitted to Tangshan People's Hospital from October 2022 to January 2024 were prospectively selected.They were randomly divided into a modeling set(182 cases)and a validation set(78 cases)in a 7:3 ratio.Based on the therapeutic effects of radiotherapy and chemotherapy,patients in the modeling set were divided into a remission group(n=66)and a non-re-mission group(n=116).Multivariate logistic regression was used to analyze factors affecting treatment efficacy,and the predic-tion model was constructed using R software.Internal validation was performed via the bootstrap method.Receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)were generated to evaluate the model's pre-dictive performance,accuracy,and clinical net benefit.Results The effective remission rate after radiotherapy and chemother-apy was 35.00%in triple-negative breast cancer patients.No significant differences were observed between the remission and non-remission groups in body mass index,menstrual status,site of disease,histological grade,or axillary lymph node status at initial diagnosis(P>0.05).In remission group,patients aged≤40 years,TNM stageⅢ,high Ki-67 expression ratio,maximum tumor diameter,and CA153 level were significantly lower than those in the non-remission group(P<0.05),while the propor-tion of high-density tumor-infiltrating lymphocytes(TILs)was higher(P<0.05).Logistic regression analysis identified age≤40 years,TNM stageⅢ,high Ki-67 expression,large tumor diameter,elevated CA153 levels,and low TIL density as independent risk factors for ineffective radiotherapy and chemotherapy(P<0.05).The modeling set and validation set showed areas under the curve(AUC)of 0.804 and 0.771,respectively.Hosmer-Lemeshow test results for both groups indicated good fit(P>0.05).DCA demonstrated substantial clinical net benefit for both nomogram models.Conclusion This study identified six indicators in-fluencing radiotherapy and chemotherapy efficacy in triple-negative breast cancer patients.The risk prediction model based on these factors demonstrates strong clinical applicability and may guide clinical decision-making to improve remission rates.