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Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy

PURPOSE: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue—spari...

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Autores principales: Dean, Jamie A., Wong, Kee H., Gay, Hiram, Welsh, Liam C., Jones, Ann-Britt, Schick, Ulrike, Oh, Jung Hun, Apte, Aditya, Newbold, Kate L., Bhide, Shreerang A., Harrington, Kevin J., Deasy, Joseph O., Nutting, Christopher M., Gulliford, Sarah L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653218/
https://www.ncbi.nlm.nih.gov/pubmed/27788955
http://dx.doi.org/10.1016/j.ijrobp.2016.08.013
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author Dean, Jamie A.
Wong, Kee H.
Gay, Hiram
Welsh, Liam C.
Jones, Ann-Britt
Schick, Ulrike
Oh, Jung Hun
Apte, Aditya
Newbold, Kate L.
Bhide, Shreerang A.
Harrington, Kevin J.
Deasy, Joseph O.
Nutting, Christopher M.
Gulliford, Sarah L.
author_facet Dean, Jamie A.
Wong, Kee H.
Gay, Hiram
Welsh, Liam C.
Jones, Ann-Britt
Schick, Ulrike
Oh, Jung Hun
Apte, Aditya
Newbold, Kate L.
Bhide, Shreerang A.
Harrington, Kevin J.
Deasy, Joseph O.
Nutting, Christopher M.
Gulliford, Sarah L.
author_sort Dean, Jamie A.
collection PubMed
description PURPOSE: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue—sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. METHODS AND MATERIALS: FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares—logistic regression [FPLS-LR] and functional principal component—logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate—response associations, assessed using bootstrapping. RESULTS: The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/−0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/−0.96, 0.79/−0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe toxicity in the PLR models. Dose levels greater than approximately 1.0 Gy/fraction were most strongly associated with severe acute mucositis and dysphagia in the FDA models. CONCLUSIONS: FPLS and functional principal component analysis marginally improved predictive performance compared with PLR and provided robust dose-response associations. FDA is recommended for use in normal tissue complication probability modeling.
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spelling pubmed-56532182017-10-23 Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy Dean, Jamie A. Wong, Kee H. Gay, Hiram Welsh, Liam C. Jones, Ann-Britt Schick, Ulrike Oh, Jung Hun Apte, Aditya Newbold, Kate L. Bhide, Shreerang A. Harrington, Kevin J. Deasy, Joseph O. Nutting, Christopher M. Gulliford, Sarah L. Int J Radiat Oncol Biol Phys Article PURPOSE: Current normal tissue complication probability modeling using logistic regression suffers from bias and high uncertainty in the presence of highly correlated radiation therapy (RT) dose data. This hinders robust estimates of dose-response associations and, hence, optimal normal tissue—sparing strategies from being elucidated. Using functional data analysis (FDA) to reduce the dimensionality of the dose data could overcome this limitation. METHODS AND MATERIALS: FDA was applied to modeling of severe acute mucositis and dysphagia resulting from head and neck RT. Functional partial least squares regression (FPLS) and functional principal component analysis were used for dimensionality reduction of the dose-volume histogram data. The reduced dose data were input into functional logistic regression models (functional partial least squares—logistic regression [FPLS-LR] and functional principal component—logistic regression [FPC-LR]) along with clinical data. This approach was compared with penalized logistic regression (PLR) in terms of predictive performance and the significance of treatment covariate—response associations, assessed using bootstrapping. RESULTS: The area under the receiver operating characteristic curve for the PLR, FPC-LR, and FPLS-LR models was 0.65, 0.69, and 0.67, respectively, for mucositis (internal validation) and 0.81, 0.83, and 0.83, respectively, for dysphagia (external validation). The calibration slopes/intercepts for the PLR, FPC-LR, and FPLS-LR models were 1.6/−0.67, 0.45/0.47, and 0.40/0.49, respectively, for mucositis (internal validation) and 2.5/−0.96, 0.79/−0.04, and 0.79/0.00, respectively, for dysphagia (external validation). The bootstrapped odds ratios indicated significant associations between RT dose and severe toxicity in the mucositis and dysphagia FDA models. Cisplatin was significantly associated with severe dysphagia in the FDA models. None of the covariates was significantly associated with severe toxicity in the PLR models. Dose levels greater than approximately 1.0 Gy/fraction were most strongly associated with severe acute mucositis and dysphagia in the FDA models. CONCLUSIONS: FPLS and functional principal component analysis marginally improved predictive performance compared with PLR and provided robust dose-response associations. FDA is recommended for use in normal tissue complication probability modeling. 2016-08-22 2016-11-15 /pmc/articles/PMC5653218/ /pubmed/27788955 http://dx.doi.org/10.1016/j.ijrobp.2016.08.013 Text en http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dean, Jamie A.
Wong, Kee H.
Gay, Hiram
Welsh, Liam C.
Jones, Ann-Britt
Schick, Ulrike
Oh, Jung Hun
Apte, Aditya
Newbold, Kate L.
Bhide, Shreerang A.
Harrington, Kevin J.
Deasy, Joseph O.
Nutting, Christopher M.
Gulliford, Sarah L.
Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy
title Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy
title_full Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy
title_fullStr Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy
title_full_unstemmed Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy
title_short Functional Data Analysis Applied to Modeling of Severe Acute Mucositis and Dysphagia Resulting From Head and Neck Radiation Therapy
title_sort functional data analysis applied to modeling of severe acute mucositis and dysphagia resulting from head and neck radiation therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653218/
https://www.ncbi.nlm.nih.gov/pubmed/27788955
http://dx.doi.org/10.1016/j.ijrobp.2016.08.013
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