影響乳癌患者接受強度調控放射治療後產生放射線皮膚炎之因子分析

為了找出影響乳癌患者接受強度調控放射治療（Intensity Modulation Radiation Therapy, IMRT）後導致放射線皮膚發炎之因子，本研究使用二元邏輯斯回歸檢定找出最適合的預測因子並建立預測模型。本研究從2016年1月至2016年12月，收集接受強度調控放射治療的30位患者進行了分析。所有患者均接受同步加強放射線治療的處方劑量。患者的放射線皮膚發炎反應的判斷時間為治療結束當週由醫師判讀，定義≥2級放射線皮膚炎為嚴重急性皮膚發炎反應。預測因子分為病患特性因子與劑量因子，經由二元邏輯斯回歸分析分別找出最重要的影響因子並使用模型曲面下面積（Area under the curve of ROC, AUC），Hosmer-Lemeshow（HL）與Omnibus檢定模型。在二元邏輯斯回歸分析中，顯著的因子為有無鎖骨上窩（Supraclavicular Fossa, SCF）照野與接受到40Gy的皮膚體積，在SCF模型中p值為0.01，勝算比為9.33，AUC為0.75，HL為0.16 omibus0.01；在V40的模型中為p值為0.01，勝算比為1.1，AUC為0.82，HL為0.19 omibus0.002，皆表示此兩個模型具有良好的鑑別度。根據這一研究，我們發現最佳的預測因子在病患特性因子為有無SCF照野，皮膚劑量因子為V40。

關鍵字

強度調控放射治療；放射線皮膚炎；二元邏輯斯回歸

並列摘要

The aim of this study was to find the prognostic factor for grade 2 acute radiation induced dermatitis after intensity modulation radiation therapy (IMRT) among breast cancer patients. From Jan 2016 to Dec 2016, 30 breast cancer patients who were referred to our department for adjuvant irradiation therapy were analyzed. The grade ≥2 radiation dermatitis was defined as the endpoint, among the patients with breast surgery. Univariate logistic regression was used for varying prognostic factor. The number of patients experiencing grade ≥2 radiation dermatitis was 20/30 (66%) in all patients. According to the univariate logistic regression we found out the best predictor for the presence or absence of Supraclavicular Fossa (SCF ) field and V40. In SCF model, the p value is 0.01, odds ratio is 9.33, the area under the curve (area under the ROC curve, AUC) is 0.75, the Hosmer-Lemeshow test is 0.16, and the Omnibus value is 0.001. In V40 model, the p value is 0.01, odds ratio is 1.1, the area under the curve (area under the ROC curve, AUC) is 0.82, the Hosmer-Lemeshow test is 0.19, and the Omnibus value is 0.002. Based on this study, we found that the best predictors were presence or absence of SCF field, V40.

並列關鍵字

intensity modulation radiation therapy (IMRT) ； radiation dermatitis ； logistic regression

國際替代計量

影響乳癌患者接受強度調控放射治療後產生放射線皮膚炎之因子分析

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