ORIGINAL RESEARCH article
Front. Public Health
Sec. Radiation and Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1614073
This article is part of the Research TopicAdvances in Radiation Research and Applications: Biology, Environment and MedicineView all 12 articles
A Nomogram Model to Predict Grade ≥2 Acute Radiation Enteritis in Elderly Patients with Cervical Cancer
Provisionally accepted
Lin Zhu1
Lijuan Wang1Yihan Wu1Ming Zhu1Xue Huang1Yan Ma1Dandan Xu1Sen Wang1Yuxing Yang1*
Xiaoting Xu2*- 1Fourth People's Hospital of Changzhou, Changzhou, China
- 2The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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Introduction: Acute Radiation Enteritis (ARE) is a common complication of pelvic radiotherapy, with incidence rates exceeding 60% in elderly populations. Especially, grade ≥2 ARE can lead to treatment interruptions, malnutrition, and even septic shock, thereby impairing patients' quality of life and survival outcomes. However, existing risk prediction models are predominantly developed based on younger populations or mixed cohorts, lacking sophisticated evaluation tools tailored to elderly patients.To establish a predictive nomogram for grade ≥2 ARE in elderly cervical cancer patients undergoing radiotherapy, a retrospective cohort study of 251 elderly cervical cancer patients who received pelvic radiotherapy between January 2018 and March 2024 was conducted. Independent risk factors identified through univariate and multivariate logistic regression were incorporated into a nomogram. The model performance was validated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).The incidence of grade ≥2 ARE in our cohort was 61.35%. Independent risk factors included age (OR=1.881, 95%CI:1.015-3.484), hypertension (OR=4.577, 95%CI:2.402-8.720), diabetes (OR=5.503, 95%CI:2.206-13.726), Dmean_R (OR=1.309, 95%CI:1.155-1.483), and lactate dehydrogenase-to-albumin ratio (LAR), (OR=1.872, 95%CI:1.381-2.538). The nomogram exhibited strong discriminative ability (0.825 (95% CI: 0.774-0.877), and excellent calibration (Hosmer-Lemeshow test, p=0.744).This nomogram integrates both clinical and dosimetric parameters to enable precise risk stratification for grade ≥2 ARE in elderly cervical cancer patients, facilitating personalized prevention strategies and optimized treatment planning.
Keywords: cervical cancer, Radiation enteritis, nomogram, elderly patients, Radiotherapy
Received: 18 Apr 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Zhu, Wang, Wu, Zhu, Huang, Ma, Xu, Wang, Yang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuxing Yang, Fourth People's Hospital of Changzhou, Changzhou, China
Xiaoting Xu, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China
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