{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:34:27Z","timestamp":1786649667243,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Glioblastoma multiforme (GBM) is an aggressive primary brain tumor requiring radiotherapy (RT), which often leads to radiation-induced alopecia (RIA), a distressing toxicity impacting quality of life. This study establishes the first normal tissue complication probability (NTCP) framework for RIA in GBM patients, comparing the Lyman-Kutcher-Burman (LKB) model and multivariate logistic regression.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n A prospective cohort of 41 GBM patients undergoing intensity-modulated RT (IMRT) was analyzed. Scalp contours were generated for dosimetric evaluation, and NTCP was modeled using the LKB framework (parameters: TD\n 50<\/jats:sub>\n = 24 Gy,\n m<\/jats:italic>\n = 0.47) and logistic regression. Dosimetric parameters and clinical variables were assessed. Model performance was evaluated via AUC-ROC, Brier score, and Hosmer-Lemeshow tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Grade 2 RIA incidence was 46.3% at 3 months and 31.7% at 6 months. Dosimetric parameters D\n max<\/jats:sub>\n and concurrent chemotherapy were significant predictors (\n P<\/jats:italic>\n < 0.05). The logistic regression model outperformed the LKB model (AUC: 0.91 vs. 0.89), demonstrating superior discrimination and calibration. For NTCP < 50%, the generalized equivalent uniform dose threshold was identified as 38 Gy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Multivariate logistic regression, integrating dosimetric and clinical factors, offers enhanced predictive accuracy for RIA compared to the LKB model. These findings emphasize the importance of optimizing IMRT plans to limit scalp dose and considering chemotherapy in risk stratification. Implementation of these models may improve patient-centered care by balancing tumor control and toxicity reduction.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/abr.abr_280_25","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T14:01:29Z","timestamp":1767103289000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Modeling Normal Tissue Complication Probability of Radiation-Induced Alopecia Following Intensity-Modulated Radiation Therapy in Glioblastoma Patients"],"prefix":"10.4103","volume":"14","author":[{"given":"Korosh","family":"Saber","sequence":"first","affiliation":[{"name":"Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnaz","family":"Roayaei","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Isfahan University of Medical Science, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Shanei","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"R2-20251230","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4103\/abr.abr_209_18","article-title":"Prostate-specific membrane antigen expression in neovasculature of glioblastoma multiforme","volume":"8","author":"Shavakhi","year":"2019","journal-title":"Adv Biomed Res"},{"key":"R3-20251230","doi-asserted-by":"crossref","first-page":"6041","DOI":"10.21873\/anticanres.12954","article-title":"Technical advances in radiation therapy for brain tumors","volume":"38","author":"Scaringi","year":"2018","journal-title":"Anticancer Res"},{"key":"R4-20251230","first-page":"224","article-title":"Current approaches and novel treatment methods for cancer and radiotherapy","volume":"4","author":"Shirzadfar","year":"2018","journal-title":"Int J Biosen Bioelectron"},{"key":"R5-20251230","doi-asserted-by":"crossref","first-page":"841","DOI":"10.5312\/wjo.v15.i9.841","article-title":"Impacts of radiation therapy on quality of life and pain relief in patients with bone metastases","volume":"15","author":"Hoveidaei","year":"2024","journal-title":"World J Orthop"},{"key":"R6-20251230","first-page":"1","article-title":"Implications of ionizing radiation exposure to patients\u2019 mental health during diagnosis and treatment: A systematic review","volume":"8","author":"Samaila","year":"2024","journal-title":"J Cancer Res Cell Ther"},{"key":"R7-20251230","first-page":"562","article-title":"A practitioner\u2019s guide to cancer-related alopecia","volume":"25","author":"Dorr","year":"1998","journal-title":"Semin Oncol"},{"issue":"Suppl_1","key":"R8-20251230","doi-asserted-by":"crossref","first-page":"i155","DOI":"10.1093\/bjd\/ljae090.327","article-title":"BI39 oncological therapies and hair disorders: A narrative approach on permanent chemotherapy-induced alopecia. 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