{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T10:52:02Z","timestamp":1757587922146,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82360630","81903257"],"award-info":[{"award-number":["82360630","81903257"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012547","name":"Guangxi Natural Science Foundation","doi-asserted-by":"publisher","award":["2020JJA140141"],"award-info":[{"award-number":["2020JJA140141"]}],"id":[{"id":"10.13039\/100012547","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to construct a nomogram to predict radiation-induced hepatic toxicity in patients with hepatocellular carcinoma treated with intensity-modulated radiotherapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study reviewed the clinical characteristics and dose\u2013volume parameters of 196 patients with hepatocellular carcinoma. Radiation-induced hepatic toxicity was defined as progression of the Child\u2013Pugh score caused by intensity-modulated radiotherapy. Factors relevant to radiation-induced hepatic toxicity were selected using receiver operating characteristic and univariate logistic analysis. A risk assessment model was developed, and its discrimination was validated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eighty-eight (44.90%) and 28 (14.29%) patients had radiation-induced hepatic toxicity \u2265 1 (Child\u2013Pugh\u00a0\u2265\u00a01) and radiation-induced hepatic toxicity \u2265 2 (Child\u2013Pugh\u00a0\u2265\u00a02). Pre-treatment Child\u2013Pugh, body mass index and dose\u2013volume parameters were correlated with radiation-induced hepatic toxicity \u2265 1 using univariate logistic analysis. V15 had the best predictive effectiveness among the dose\u2013volume parameters in both the training (area under the curve: 0.763, 95% confidence interval: 0.683\u20130.842, P\u00a0&amp;lt;\u00a00.001) and validation cohorts (area under the curve: 0.759, 95% confidence interval: 0.635\u20130.883, P\u00a0&amp;lt;\u00a00.001). The area under the curve values of the model that was constructed by pre-treatment Child\u2013Pugh, body mass index and V15 for radiation-induced hepatic toxicity \u22651 were 0.799 (95% confidence interval: 0.719\u20130.878, P\u00a0&amp;lt;\u00a00.001) and 0.775 (95% confidence interval: 0.657\u20130.894, P\u00a0&amp;lt;\u00a00.001) in the training and validation cohorts, respectively. Patients with a body mass index\u00a0\u2264\u00a020.425, Barcelona clinic liver cancer\u00a0=\u00a0C, Hepatitis B Virus-positive, Eastern Cooperative Oncology Group\u00a0=\u00a01\u20132 and hepatic fibrosis require lower V15 dose limits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Risk assessment model constructed from Pre-treatment Child\u2013Pugh, V15 and body mass index can guide individualized patient selection of toxicity minimization strategies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyae024","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T16:07:27Z","timestamp":1708445247000},"page":"699-707","source":"Crossref","is-referenced-by-count":2,"title":["Development and validation of a nomogram for radiation-induced hepatic toxicity after intensity modulated radiotherapy for hepatocellular carcinoma: a retrospective 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for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston , Houston, TX, USA, and Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianxu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Guangxi Medical University Cancer Hospital , Nanning , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Guangxi Medical University Cancer Hospital , Nanning , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingshi","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Guangxi Medical University Cancer Hospital , Nanning , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9652-4890","authenticated-orcid":false,"given":"Shixiong","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Guangxi Medical University Cancer Hospital , Nanning , China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,19]]},"reference":[{"key":"2024060203004688400_ref1","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/S0140-6736(22)01200-4","article-title":"Hepatocellular 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