Prediction model of radiation enteritis under the total neoadjuvant therapy for locally advanced rectal cancer
10.3760/cma.j.cn112271-20250209-00046
- VernacularTitle:局部进展期直肠癌全程新辅助治疗相关放射性肠炎的预测模型研究
- Author:
Yi FU
1
;
Chenying MA
1
;
Shuyue LI
1
;
Jie CHEN
1
;
Guanghui GAN
1
;
Juying ZHOU
1
Author Information
1. 苏州大学附属第一医院放疗科，苏州 215006
- Publication Type:Journal Article
- Keywords:
Rectal tumor;
Radiotherapy;
Acute radiation enteritis;
Nutritional indicators;
Total neoadjuvant therapy
- From:
Chinese Journal of Radiological Medicine and Protection
2025;45(8):757-765
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze relevant factors influencing severe acute radiation enteritis (SARE) during total neoadjuvant therapy (TNT) for locally advanced rectal cancer (LARC). To identify specific prediction indicators of the occurrence and progression of radiation enteritis by investigating the effect relationships between radiation enteritis and multidimensional factors.Methods:A total of 92 patients with rectal adenocarcinoma who received total neoadjuvant therapy at the First Affiliated Hospital of Soochow University from January 2020 to September 2023 were enrolled in this study. Their relevant information was collected, encompassing clinical nutritional indicators, dynamic changes in hematological parameters, systemic inflammatory indicators, and the occurrence of adverse reactions. Then, risk factors associated with radiation enteritis were determined using logistic regression analysis. Based on independent risk factors, a nomogram model for risk prediction was constructed.Results:Univariate analysis revealed significant correlations of the SARE occurrence with certain nutritional indicators, local tumor measurement data, and laboratory parameters. Multivariate regression analysis further identified the independent risk factors for SARE occurrence, including albumin reduction >26.5% before vs. after treatment ( OR = 5.010, 95% CI: 1.766-14.154, P = 0.010), rectual tenesmus rating of Grade 1-3 ( OR = 3.639, 95% CI: 1.425-9.300, P = 0.024), and elevated disease activity index (DAI) score ( OR ≈ 7.683 per 1-point increase, 95% CI: 1.105-53.410, P = 0.039). The prediction model constructed based on these factors demonstrated high prediction efficiency (AUC = 0.841; 95% CI: 0.749-0.934). Conclusions:The nomogram model constructed using albumin reduction, rectal tenesmus rating, and DAI score can provide accurate, simple, and low-cost risk prediction of radiation enteritis during TNT for LARC patients. This model facilitates the early clinical identification of high-risk patients, providing a basis for implementing personalized adjustments to radiotherapy regimens and enhancing nutritional interventions.
