{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:21:04Z","timestamp":1780626064539,"version":"3.54.1"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:00:00Z","timestamp":1712966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health &amp; Welfare, Republic of Korea","award":["HA22C0044"],"award-info":[{"award-number":["HA22C0044"]}]},{"name":"Ministry of Health &amp; Welfare, Republic of Korea","award":["NRF#2022R1F1A106345712"],"award-info":[{"award-number":["NRF#2022R1F1A106345712"]}]},{"name":"Ministry of Science and Information &amp; Communication Technology","award":["HA22C0044"],"award-info":[{"award-number":["HA22C0044"]}]},{"name":"Ministry of Science and Information &amp; Communication Technology","award":["NRF#2022R1F1A106345712"],"award-info":[{"award-number":["NRF#2022R1F1A106345712"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: We aimed to construct an expert knowledge-based Bayesian network (BN) model for assessing the overall disease burden (ODB) in (y)pN1 breast cancer patients and compare ODB across arms of ongoing trials. Methods: Utilizing institutional data and expert surveys, we developed a BN model for (y)pN1 breast cancer. Expert-derived probabilities and disability weights for radiotherapy-related benefit (e.g., 7-year disease-free survival [DFS]) and toxicities were integrated into the model. ODB was defined as the sum of disability weights multiplied by probabilities. In silico predictions were conducted for Alliance A011202, PORT-N1, RAPCHEM, and RT-CHARM trials, comparing ODB, 7-year DFS, and side effects. Results: In the Alliance A011202 trial, 7-year DFS was 80.1% in both arms. Axillary lymph node dissection led to higher clinical lymphedema and ODB compared to sentinel lymph node biopsy with full regional nodal irradiation (RNI). In the PORT-N1 trial, the control arm (whole-breast irradiation [WBI] with RNI or post-mastectomy radiotherapy [PMRT]) had an ODB of 0.254, while the experimental arm (WBI alone or no PMRT) had an ODB of 0.255. In the RAPCHEM trial, the radiotherapy field did not impact the 7-year DFS in ypN1 patients. However, there was a mild ODB increase with a larger irradiation field. In the RT-CHARM trial, we identified factors associated with the major complication rate, which ranged from 18.3% to 22.1%. Conclusions: The expert knowledge-based BN model predicted ongoing trial outcomes, validating reported results and assumptions. In addition, the model demonstrated the ODB in different arms, with an emphasis on quality of life.<\/jats:p>","DOI":"10.3390\/cancers16081494","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T03:56:13Z","timestamp":1713153373000},"page":"1494","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prediction of Overall Disease Burden in (y)pN1 Breast Cancer Using Knowledge-Based Machine Learning Model"],"prefix":"10.3390","volume":"16","author":[{"given":"Seok-Joo","family":"Chun","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Department of Radiation Oncology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang 10326, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7064-9855","authenticated-orcid":false,"given":"Bum-Sup","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Department of Radiation Oncology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeon Seok","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5921-5522","authenticated-orcid":false,"given":"Ji Hyun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Department of Radiation Oncology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Hwan","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Republic of Korea"},{"name":"Department of Radiation Oncology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea"},{"name":"Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Division for Breast Cancer, Korean Radiation Oncology Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,13]]},"reference":[{"key":"ref_1","unstructured":"(2023). 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