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

Authors

  • Isabelle Kindts Department of Oncology, Experimental Radiation Oncology, KU Leuven – University of Leuven, Leuven, Belgium;  Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
  • Gilles Defraene Department of Oncology, Experimental Radiation Oncology, KU Leuven – University of Leuven, Leuven, Belgium
  • Annouschka Laenen Leuven Biostatistics and Statistical Bioinformatics Centre (L-Biostat), KU Leuven University, Leuven, Belgium
  • Saskia Petillion Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
  • Erik Van Limbergen Department of Oncology, Experimental Radiation Oncology, KU Leuven – University of Leuven, Leuven, Belgium;  Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
  • Tom Depuydt Department of Oncology, Experimental Radiation Oncology, KU Leuven – University of Leuven, Leuven, Belgium;  Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
  • Caroline Weltens Department of Oncology, Experimental Radiation Oncology, KU Leuven – University of Leuven, Leuven, Belgium;  Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium

DOI:

https://doi.org/10.1080/0284186X.2018.1461926

Abstract

Purpose/Objectives: To develop a normal tissue complication probability (NTCP) model for late unfavourable aesthetic outcome (AO) after breast-conserving therapy.

Material and Methods: The BCCT.core software evaluated the AO using standardized photographs of patients treated between 2009 and 2014. Dose maps in 2 Gy equivalents were calculated assuming α/β = 3.6 Gy. Uni- and multivariable logistic regression analysis was performed to study the predictive value of clinicopathological and dosimetric variables for unfavourable AO. The Lyman Kutcher Burman (LKB) model was fit to the data with dose modifying factors (dmf). Model performance was assessed with the area under the curve (AUC) of the receiver operating characteristic curve and bootstrap sampling.

Results: Forty-four of the 121 analysed patients (36%) developed unfavourable AO. In the optimal multivariable logistic regression model, a larger breast volume receiving ≥55 Gy (V55), a seroma and an axillary lymph node dissection (ALND) were independently associated with an unfavourable AO, AUC = 0.75 (95%CI 0.64;0.85). Beta-estimates were −2.68 for β0, 0.057 for V55, 1.55 for seroma and 1.20 for ALND. The optimal LKB model parameters were EUD3.6(50) = 63.3 Gy, n = 1.00, m = 0.23, dmf(seroma) = 0.83 and dmf(ALND) = 0.84, AUC = 0.74 (95%CI 0.61;0.83).

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

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Published

2018-07-03

How to Cite

Kindts, I., Defraene, G., Laenen, A., Petillion, S., Van Limbergen, E., Depuydt, T., & Weltens, C. (2018). Development of a normal tissue complication probability model for late unfavourable aesthetic outcome after breast-conserving therapy. Acta Oncologica, 57(7), 916–923. https://doi.org/10.1080/0284186X.2018.1461926

Issue

Vol. 57 No. 7 (2018): Acta Oncologica

Section

Articles