Skip to main content

ORIGINAL RESEARCH article

Front. Med.
Sec. Pulmonary Medicine
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1428456
This article is part of the Research Topic Next Generation In Vitro Models to Study Chronic Pulmonary Diseases - Volume II View all 3 articles

Analysis of risk factors for pneumothorax after particle implantation in the treatment of advanced lung cancer after surgery and establishment of a nomogram prediction model

Provisionally accepted
Tingting Ding Tingting Ding Shanhu Hao Shanhu Hao *Zhiguo Wang Zhiguo Wang Wenwen Zhang Wenwen Zhang Guoxu Zhang Guoxu Zhang *
  • Northern Theater Command General Hospital, Shenyang, China

The final, formatted version of the article will be published soon.

    Objective: To analyze the risk factors for pneumothorax after particle implantation in the treatment of advanced lung cancer and to construct and validate a nomogram prediction model. Methods: A retrospective analysis was conducted on 148 patients who underwent 125 I particle implantation for advanced lung cancer at the *** from December 2022 to December 2023. Potential risk factors were identified using univariate logistic regression analysis, followed by a multivariate logistic regression analysis to evaluate the predictive factors for pneumothorax. Interaction effects between variables were studied and incorporated into the model construction. ROC curves and nomograms were generated for visualization. Calibration analysis was performed, and the corresponding net benefit was calculated to adjust the predictive model. Results: Among the 148 patients, 58 (39.19%) experienced pneumothorax, with a mean age of 62.5 (55.25, 70) years. Multivariate analysis showed that the angle between the puncture needle and the pleura <50 °(P=0.002, OR: 3.908, CI:1.621-9.422), preoperative CT suggesting emphysema (P=0.002, OR: 3.798, CI:1.600-9.016), atelectasis (P=0.009, OR: 3.156, CI: 1.331-7.481), and lesion located in the left lung fissure (P=0.008, OR: 4.675, CI: 14.683) were independent risk factors for pneumothorax after particle implantation in the treatment of advanced lung cancer.Preoperative CT suggesting lesions in the left lung fissure or suggesting emphysema had a significant impact in the nomogram, with probabilities of pneumothorax occurrence at 40% and 38%, respectively. The predictive AUC for the above four risk factors for pneumothorax after particle implantation in the treatment of lung adenocarcinoma was 0.837 (95% CI: 0.767-0.908). When the Youden index was 0.59, the sensitivity was 85.56%, specificity was 74.13%, accuracy was 81.01%, positive predictive value was 83.69%, and negative predictive value was 76.78%.The angle between the puncture needle and the pleura <50 °, preoperative CT suggesting emphysema, atelectasis, and lesion located in the left lung fissure are independent risk factors for pneumothorax after particle implantation in the treatment of advanced lung cancer. Preoperative planning of the puncture path should avoid lung bullae, interlobar fissures, areas of severe emphysema, and atelectasis.

    Keywords: Particle implantation, close-range radiotherapy, Pneumothorax, Nomogram model, Advanced lung cancer

    Received: 06 May 2024; Accepted: 04 Oct 2024.

    Copyright: © 2024 Ding, Hao, Wang, Zhang and Zhang. 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:
    Shanhu Hao, Northern Theater Command General Hospital, Shenyang, China
    Guoxu Zhang, Northern Theater Command General Hospital, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.