Development of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

Kindts, Isabelle; Defraene, Gilles; Laenen, Annouschka; Petillion, S.; Limbergen, Erik; Depuydt, Tom; Weltens, Caroline

doi:10.1080/0284186x.2018.1461926

Cited by 5 publications

(10 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The model performed well with an Area Under the Curve (AUC) of the receiver operating curve 0.76 and bootstrap resampling resulting in AUC 0.75. The Hosmer-Lemeshow test assessing calibration was not significant, indicating good agreement between expected and observed unfavourable AO rates [11].…”

Section: Ntcp Modelmentioning

confidence: 87%

“…Currently, aesthetic outcome (AO) is becoming increasingly important because it influences the quality of life and psychosocial recovery after breast cancer treatment. An NTCP model to predict for the risk of long-term AO has previously been developed by our research group [11]. The nomogram included three variables: seroma, ALND and V55.…”

Section: Discussionmentioning

confidence: 99%

“…The primary aim of the study was to validate the following NTCP model for late unfavourable AO: NTCP =1/(1 þ e Àt ), where t = À2.6759þ(0.0574 Â V55) þ 1.5546 (if seroma þ 1.2029 (if ALND) (ALND ¼ axillary lymph node dissection) [11]. The NTCP model was developed based on 121 retrospectively evaluated patients treated between two and six years ago of whom 44 (36%) developed unfavourable AO.…”

Section: Ntcp Modelmentioning

confidence: 99%

“…Recently, a prediction model for late unfavourable AO has been developed taking into account clinicopathological variables and dose-volume metrics [11]. An objective and thorough validation of an NTCP model is mandatory before its widespread implementation as a useful clinical tool.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Validation of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

et al. 2019

Self Cite

View full text Add to dashboard Cite

Purpose: To validate a normal tissue complication probability (NTCP) model for late unfavourable aesthetic outcome (AO) after breast-conserving therapy. Materials/Methods: The BCCT.core software evaluated the AO using standardized photographs of patients treated at the University Hospitals Leuven between April 2015 and April 2016. Dose maps in 2 Gy equivalents were calculated assuming a/b ¼ 3.6 Gy. The discriminating ability of the model was described by the AUC of the receiver operating characteristic curve. A 95% confidence interval (CI) of AUC was calculated using 10,000 bootstrap replications. Calibration was evaluated with the calibration plot and Nagelkerke R 2. Patients with unfavourable AO at baseline were excluded. Patient, tumour and treatment characteristics were compared between the development and the validation cohort. The prognostic value of the characteristics in the validation cohort was further evaluated in univariable and multivariable analysis. Results: Out of 175 included patients, 166 were evaluated two years after RT and 44 (26.51%) had unfavourable AO. AUC was 0.66 (95% CI 0.56; 0.76). Calibration was moderate with small overestimations at higher risk. When applying all of the univariable significant clinicopathological and dosimetrical variables from the validation cohort in a multivariable model, the presence of a seroma and V45 were selected as significant risk factors for unfavourable AO (Odds Ratio 4.40 (95% CI 1.96; 9.86) and 1.14 (95% CI 1.03; 1.27), p-value <.001 and .01, respectively). Conclusions: The NTCP model for unfavourable AO shows a moderate discrimination and calibration in the present prospective validation cohort with a small overestimation in the high risk patients.

show abstract

Section: Ntcp Modelmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Ntcp Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Validation of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Relative risk (RR) ratios comparison according to normal tissue complication probability analysis for severe acute skin toxicity for intensity modulated proton plan without (IMPT 1 ) and with skin included in the cost function (IMPT 2 Severe acute skin reactions may be prodromal of consequential skin late effects [36] and prevention of these acute reactions may also avoid late effects which can impact on esthetic outcome and quality of life. Recently Kindts et al [37] developed a prediction model for late unfavorable esthetic outcome for breast-conserving therapy taking into account clinicopathological and dosimetric variables. The authors identified seroma, axillary lymphadenectomy, and breast volume receiving more than 55 Gy as predictive factors.…”

Section: Discussionmentioning

confidence: 99%

Potential skin morbidity reduction with intensity-modulated proton therapy for breast cancer with nodal involvement

et al. 2019

View full text Add to dashboard Cite

2019) Potential skin morbidity reduction with intensity-modulated proton therapy for breast cancer with nodal involvement, Acta Oncologica, 58:6, 934-942, ABSTRACT Background: Different modern radiation therapy treatment solutions for breast cancer (BC) and regional nodal irradiation (RNI) have been proposed. In this study, we evaluate the potential reduction in radiation-induced skin morbidity obtained by intensity modulated proton therapy (IMPT) compared with intensity modulated photon therapy (IMXT) for left-side BC and RNI. Material and Methods: Using CT scans from 10 left-side BC patients, treatment plans were generated using IMXT and IMPT techniques. A dose of 50 Gy (or Gy [RBE] for IMPT) was prescribed to the target volume (involved breast, the internal mammary, supraclavicular, and infraclavicular nodes). Two single filed optimization IMPT (IMPT 1 and IMPT 2 ) plans were calculated without and with skin optimization. For each technique, skin dose-metrics were extracted and normal tissue complication probability (NTCP) models from the literature were employed to estimate the risk of radiation-induced skin morbidity. NTCPs for relevant organs-at-risk (OARs) were also considered for reference. The non-parametric Anova (Friedman matched-pairs signed-rank test) was used for comparative analyses. Results: IMPT improved target coverage and dose homogeneity even if the skin was included into optimization strategy (HI IMPT2 ¼ 0.11 vs. HI IMXT ¼ 0.22 and CI IMPT2 ¼ 0.96 vs. CI IMXT ¼ 0.82, p < .05). A significant relative skin risk reduction (RR ¼ NTCP IMPT /NTCP IMXT ) was obtained with IMPT 2 including the skin in the optimization with a RR reduction ranging from 0.3 to 0.9 depending on the analyzed skin toxicity endpoint/model. Both IMPT plans attained significant OARs dose sparing compared with IMXT. As expected, the heart and lung doses were significantly reduced using IMPT. Accordingly, IMPT always provided lower NTCP values. Conclusions: IMPT guarantees optimal target coverage, OARs sparing, and simultaneously minimizes the risk of skin morbidity. The applied model-based approach supports the potential clinical relevance of IMPT for left-side BC and RNI and might be relevant for the setup of cost-effectiveness evaluation strategies based on NTCP predictions, as well as for establishing patient selection criteria. ARTICLE HISTORY

show abstract

Spectrum of ultrasound findings in patients with history of breast conservative treatment

Katouli,

Bayani,

Azizinik

et al. 2023

J of Clinical Ultrasound

View full text Add to dashboard Cite

Breast conservative treatment (BCT) is currently accepted as the standard treatment option for breast cancer. Targeted ultrasound helps detect recurrent lesions, postoperative changes, and scarring tissue. In this pictorial essay, we review the ultrasound features of benign (seroma, hematoma, fat necrosis, traumatic neuroma, fibrosis/scarring) and malignant (recurrence, new primary cancer) causes of palpable lumps after BCT and provide images from our patients to illustrate some typical findings of common pathologies. Ultrasound, especially as an adjunct to mammography, can make a specific diagnosis in most cases.

show abstract

Development of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

Abstract: An NTCP model for late unfavourable AO after breast-conserving therapy was developed including seroma, axillary lymphadenectomy and V55.

Cited by 5 publications

References 38 publications

Validation of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

Validation of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy

Potential skin morbidity reduction with intensity-modulated proton therapy for breast cancer with nodal involvement

Spectrum of ultrasound findings in patients with history of breast conservative treatment

Contact Info

Product

Resources

About