Nomogram to Predict Radiation Enteritis in Cervical Squamous Cell Carcinoma

PURPOSE: To investigate the risk factors of radiation enteritis in patients with cervical cancer after radiotherapy. PATIENTS AND METHODS: Retrospective analysis 90 cervical cancer patients receiving radiation therapy from January 2019 to May 2021 in Hefei Cancer Hospital, Chinese Academy of Sciences. The patients were divided into radiation enteritis group and control group according to the radiation enteritis, the continuous variable were analyzed by ROC to obtain the best truncation value, and univariate and multifactorial logistic regression models analyzed the independent risk factors for radiation enteritis in cervical cancer patients. Nomogram was constructed and evaluated based on independent risk factors. RESULTS: The radiation enteritis incidence rate was 35.56%. Univariate analysis found that hemoglobin (OR=4.25, 95% CI=1.43~13.73), albumin (OR=2.33, 95% CI=0.95~5.83), hypertension (OR=3.57, 95% CI=1.24~10.90), sigmoid colon V45(OR=0.41, 95% CI=0.15~1.03), external radiation dose (OR=0.45, 95% CI=0.18~1.08), age (OR=2.27, 95% CI=0.90~6.18), total T lymphocyte count (OR=2.4, 95% CI=0.97~6.29)(p<0.1) are risk factors for radiation enteritis. Multivariate logistic regression analysis found that hemoglobin (p=0.001, OR=13.22, 95% CI=3.03~72.65), albumin (p=0.003, OR=6.76, 95% CI=2.08~25.67), total T lymphocyte count (p=0.015, OR=4.79, 95% CI=1.45~13.38) were independent risk factors for radiation enteritis. Based on the above predictors, a nomogram model is established, and the area under the model fit, C-index, and ROC curve indicates that the model has good prediction efficiency and differentiation. CONCLUSION: Hemoglobin, albumin, and total T lymphocyte count are risk factors for radiation enteritis in cervical cancer patients under radiotherapy, the nomogram model based on the above risk factors has good predictive efficacy and can provide a reference for radiation enteritis prediction.