Risk Factors for the Prognosis of Recurrent High-Grade Glioma Patients Undergoing Gamma Knife Radiotherapy and Construction of Risk Prediction Models
Objective To analyze the risk factors for the prognosis of recurrent high-grade glioma patients undergoing gamma knife radiotherapy and construct a risk prediction model.Methods A retrospective collection of clinical data was conducted on 85 patients with recurrent high-grade glioma who underwent gamma knife radiotherapy at the hospital from January 2019 to January 2022.The data were divided into a mortality group(40 cases)and a survival group(45 cases)based on the prognosis during the one year follow-up period.Cox regression analysis was used to analyze the factors that affect the prognosis of patients with recurrent high-grade glioma undergoing gamma knife radiotherapy.A risk prediction model was constructed based on the regression analysis results,and a column chart was constructed using R software.The predictive efficacy of the risk model was evaluated by plotting the receiver operating characteristic curve.Results The age and maximum tumor diameter of the mortality group were larger than those of the survival group,while the peripheral dose of the target area and Karnofsky functional state(KPS)score before radiotherapy were lower than those of the survival group,with statistical significant differences(P＜0.05).Cox regression analysis showed that age and maximum tumor diameter were risk factors for mortality after gamma knife radiotherapy in patients with recurrent high-grade gliomas(HR＞1,P＜0.05),while peripheral dose to the target area and pre radiotherapy KPS score were protective factors for mortality after gamma knife radiotherapy in patients with recurrent high-grade gliomas(HR＜1,P＜0.05).A nomogram was drawn to construct a prognostic risk prediction model for gamma knife radiotherapy in patients with recurrent high-grade glioma.The model discrimination showed a consistency index(C-index)value of 0.876,with good discrimination.The standard curve showed that the calibration curve was close to the Y-X straight line,and the accuracy of the model was good.Conclusion Age,peripheral dose to the target area,maximum tumor diameter and KPS score are the influencing factors for the prognosis of recurrent high-grade glioma patients undergoing gamma knife radiotherapy.The risk model constructed based on these factors has high predictive value for the prognosis of recurrent high-grade glioma patients undergoing gamma knife radiotherapy,and has good clinical application value.
high-grade gliomarecurrencegamma knife radiotherapyprognosisinfluencing factorsrisk prediction model
万方数据
维普
