A nomogram to predict symptomatic epilepsy in patients with radiation-induced brain necrosis.

Authors

• Xiaolong Huang
• Xiaoni Zhang
• Xicheng Wang
• Xiaoming Rong
• Yi Li
• Honghong Li
• Jingru Jiang
• Jinhua Cai
• Xiaohuang Zhuo
• Yaxuan Pi
• Jinpeng Lin
• Melvin L K Chua
• Andreas A Argyriou
• Simona Lattanzi
• Charles B Simone
• Jon Glass
• Joshua D Palmer
• Edward Chow
• Paul D Brown
• Zongwei Yue
• Yamei Tang

Publication/Presentation Date

9-8-2020

Abstract

OBJECTIVE: To develop and validate a nomogram to predict epilepsy in patients with radiation-induced brain necrosis (RN).

METHODS: The nomogram was based on a retrospective analysis of 302 patients who were diagnosed with symptomatic RN from January 2005 to January 2016 in Sun Yat-sen Memorial Hospital using the Cox proportional hazards model. Discrimination of the nomogram was assessed by the concordance index (

RESULTS: A total of 302 patients with RN with a median follow-up of 3.43 years (interquartile range 2.54-5.45) were included in the training cohort; 65 (21.5%) developed symptomatic epilepsy during follow-up. Seven variables remained significant predictors of epilepsy after multivariable analyses: MRI lesion volume, creatine phosphokinase, the maximum radiation dose to the temporal lobe, RN treatment, history of hypertension and/or diabetes, sex, and total cholesterol level. In the validation cohort, 28 out of 128 (21.9%) patients had epilepsy after RN within a median follow-up of 3.2 years. The nomogram showed comparable discrimination between the training and validation cohort (corrected

CONCLUSION: Our study developed an easily applied nomogram for the prediction of RN-related epilepsy in a large RN cohort.

CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that a nomogram predicts post-RN epilepsy.

Volume

95

Issue

10

First Page

1392

Last Page

1392

ISSN

1526-632X

Published In/Presented At

Huang, X., Zhang, X., Wang, X., Rong, X., Li, Y., Li, H., Jiang, J., Cai, J., Zhuo, X., Pi, Y., Lin, J., Chua, M. L. K., Argyriou, A. A., Lattanzi, S., Simone, C. B., 2nd, Glass, J., Palmer, J. D., Chow, E., Brown, P. D., Yue, Z., … AME Radiation Oncology Collaborative Group (2020). A nomogram to predict symptomatic epilepsy in patients with radiation-induced brain necrosis. Neurology, 95(10), e1392–e1403. https://doi.org/10.1212/WNL.0000000000010190

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

32631922

Department(s)

Administration and Leadership

Document Type

Article