{"id":"https://openalex.org/W7222467498","doi":"https://doi.org/10.3892/ol.2026.15909","title":"An interpretable machine\u2011learning model to predict moderate\u2011to\u2011severe acute radiation esophagitis following regional nodal irradiation for breast cancer","display_name":"An interpretable machine\u2011learning model to predict moderate\u2011to\u2011severe acute radiation esophagitis following regional nodal irradiation for breast cancer","publication_year":2026,"publication_date":"2026-10-16","ids":{"openalex":"https://openalex.org/W7222467498","doi":"https://doi.org/10.3892/ol.2026.15909","pmid":"https://pubmed.ncbi.nlm.nih.gov/42948379","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13711150"},"language":"en","primary_location":{"id":"doi:10.3892/ol.2026.15909","doi":"https://doi.org/10.3892/ol.2026.15909","is_oa":true,"landing_page_url":"https://doi.org/10.3892/ol.2026.15909","pdf_url":"http://www.spandidos-publications.com/10.3892/ol.2026.15909/download","source":{"id":"https://openalex.org/S58832373","display_name":"Oncology Letters","issn_l":"1792-1074","issn":["1792-1074","1792-1082"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320412","host_organization_name":"Spandidos Publishing","host_organization_lineage":["https://openalex.org/P4310320412"],"host_organization_lineage_names":["Spandidos Publishing"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Oncology Letters","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"http://www.spandidos-publications.com/10.3892/ol.2026.15909/download","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5158864840","display_name":"Bin He","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bin He","raw_affiliation_strings":["Department of Oncology and Radiotherapy, Chengdu Qingbaijiang District People's Hospital, Chengdu, Sichuan 610300, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Oncology and Radiotherapy, Chengdu Qingbaijiang District People's Hospital, Chengdu, Sichuan 610300, P.R. China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5083006407","display_name":"Zhongchun Qi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210160531","display_name":"Chinese People's Liberation Army","ror":"https://ror.org/05tf9r976","country_code":"CN","type":"government","lineage":["https://openalex.org/I4210160531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Zhongchun Qi","raw_affiliation_strings":["Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China","institution_ids":["https://openalex.org/I4210160531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5140896564","display_name":"Hengdi Zhang","orcid":"https://orcid.org/0000-0003-2493-4281","observed_orcids":["https://orcid.org/0000-0003-2493-4281"]},"institutions":[{"id":"https://openalex.org/I4210160531","display_name":"Chinese People's Liberation Army","ror":"https://ror.org/05tf9r976","country_code":"CN","type":"government","lineage":["https://openalex.org/I4210160531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hengdi Zhang","raw_affiliation_strings":["Department of Ophthalmology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Ophthalmology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China","institution_ids":["https://openalex.org/I4210160531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5158870107","display_name":"Linling Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I207528943","display_name":"Chengdu Medical College","ror":"https://ror.org/01c4jmp52","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I207528943"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Linling Li","raw_affiliation_strings":["School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China","institution_ids":["https://openalex.org/I207528943"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5158865897","display_name":"Hua Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210160531","display_name":"Chinese People's Liberation Army","ror":"https://ror.org/05tf9r976","country_code":"CN","type":"government","lineage":["https://openalex.org/I4210160531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hua Li","raw_affiliation_strings":["Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China","institution_ids":["https://openalex.org/I4210160531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5108907523","display_name":"Xinyun Zou","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210160531","display_name":"Chinese People's Liberation Army","ror":"https://ror.org/05tf9r976","country_code":"CN","type":"government","lineage":["https://openalex.org/I4210160531"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xinyun Zou","raw_affiliation_strings":["Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China","institution_ids":["https://openalex.org/I4210160531"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5140413407","display_name":"Yu Tan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I207528943","display_name":"Chengdu Medical College","ror":"https://ror.org/01c4jmp52","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I207528943"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yu Tan","raw_affiliation_strings":["School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan 610500, P.R. China","institution_ids":["https://openalex.org/I207528943"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5158885343","display_name":"Ling Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210160531","display_name":"Chinese People's Liberation Army","ror":"https://ror.org/05tf9r976","country_code":"CN","type":"government","lineage":["https://openalex.org/I4210160531"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Ling Zhang","raw_affiliation_strings":["Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China","institution_ids":["https://openalex.org/I4210160531"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5153666819","display_name":"Fangyuan Kong","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210160531","display_name":"Chinese People's Liberation Army","ror":"https://ror.org/05tf9r976","country_code":"CN","type":"government","lineage":["https://openalex.org/I4210160531"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Fangyuan Kong","raw_affiliation_strings":["Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Oncology, The General Hospital of Western Theater Command of The Chinese People's Liberation Army, Chengdu, Sichuan 610083, P.R. China","institution_ids":["https://openalex.org/I4210160531"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5153666819","https://openalex.org/A5158885343"],"corresponding_institution_ids":["https://openalex.org/I4210160531"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.81836769,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"32","issue":"6","first_page":"1","last_page":"17"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10619","display_name":"Esophageal Cancer Research and Treatment","score":0.4336000084877014,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10619","display_name":"Esophageal Cancer Research and Treatment","score":0.4336000084877014,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10183","display_name":"Breast Cancer Treatment Studies","score":0.12300000339746475,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T12422","display_name":"Radiomics and Machine Learning in Medical Imaging","score":0.09629999846220016,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/acute-radiation-esophagitis","display_name":"acute radiation esophagitis","score":0.9800000190734863},{"id":"https://openalex.org/keywords/breast-cancer","display_name":"breast cancer","score":0.8690000176429749},{"id":"https://openalex.org/keywords/regional-nodal-irradiation","display_name":"regional nodal irradiation","score":0.9649999737739563},{"id":"https://openalex.org/keywords/radiation-toxicity-prediction","display_name":"radiation toxicity prediction","score":0.7850000262260437},{"id":"https://openalex.org/keywords/model-interpretability","display_name":"model interpretability","score":0.984000027179718},{"id":"https://openalex.org/keywords/esophageal-toxicity","display_name":"esophageal toxicity","score":0.5199999809265137}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8377000093460083},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.675000011920929},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.5871999859809875},{"id":"https://openalex.org/C83330619","wikidata":"https://www.wikidata.org/wiki/Q21124872","display_name":"NODAL","level":2,"score":0.5656999945640564},{"id":"https://openalex.org/C509974204","wikidata":"https://www.wikidata.org/wiki/Q180507","display_name":"Radiation therapy","level":2,"score":0.5616000294685364},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.5059999823570251},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3898000121116638},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.3898000121116638},{"id":"https://openalex.org/C2779920096","wikidata":"https://www.wikidata.org/wiki/Q298230","display_name":"Esophagitis","level":4,"score":0.32919999957084656},{"id":"https://openalex.org/C111337013","wikidata":"https://www.wikidata.org/wiki/Q2737837","display_name":"Irradiation","level":2,"score":0.30790001153945923},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.25540000200271606}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.3892/ol.2026.15909","doi":"https://doi.org/10.3892/ol.2026.15909","is_oa":true,"landing_page_url":"https://doi.org/10.3892/ol.2026.15909","pdf_url":"http://www.spandidos-publications.com/10.3892/ol.2026.15909/download","source":{"id":"https://openalex.org/S58832373","display_name":"Oncology Letters","issn_l":"1792-1074","issn":["1792-1074","1792-1082"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320412","host_organization_name":"Spandidos Publishing","host_organization_lineage":["https://openalex.org/P4310320412"],"host_organization_lineage_names":["Spandidos Publishing"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Oncology Letters","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13711150","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13711150/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13711150/pdf/ol-32-06-15909.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Oncol Lett","raw_type":"Text"},{"id":"pmid:42948379","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42948379","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Oncology letters","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.3892/ol.2026.15909","doi":"https://doi.org/10.3892/ol.2026.15909","is_oa":true,"landing_page_url":"https://doi.org/10.3892/ol.2026.15909","pdf_url":"http://www.spandidos-publications.com/10.3892/ol.2026.15909/download","source":{"id":"https://openalex.org/S58832373","display_name":"Oncology Letters","issn_l":"1792-1074","issn":["1792-1074","1792-1082"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","jufo-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320412","host_organization_name":"Spandidos Publishing","host_organization_lineage":["https://openalex.org/P4310320412"],"host_organization_lineage_names":["Spandidos Publishing"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Oncology Letters","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320329835","display_name":"Chinese People\u2019s Liberation Army","ror":"https://ror.org/05tf9r976"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7222467498.pdf","grobid_xml":"https://content.openalex.org/works/W7222467498.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4409514619","https://openalex.org/W7197003458","https://openalex.org/W7221134000","https://openalex.org/W4403251825","https://openalex.org/W4387206705","https://openalex.org/W2760591741","https://openalex.org/W7215848974","https://openalex.org/W4414771260","https://openalex.org/W2556147691","https://openalex.org/W6939539363"],"abstract_inverted_index":{"Acute":[0],"radiation":[1],"esophagitis":[2],"(ARE)":[3],"is":[4,236],"a":[5,50,55,155,160,166,208],"clinically":[6],"relevant":[7],"toxicity":[8],"occurring":[9],"in":[10],"patients":[11,41],"with":[12,126],"breast":[13],"cancer":[14],"receiving":[15,84],"post-operative":[16],"regional":[17],"nodal":[18],"irradiation.":[19],"The":[20,202],"present":[21,215],"study":[22,216],"aimed":[23],"to":[24,49,178],"develop":[25],"and":[26,54,79,122,129,133,165,180,195,210,228],"evaluate":[27],"an":[28,143],"interpretable":[29],"machine-learning":[30],"(ML)":[31],"model":[32,117,131,204,222],"for":[33],"grade":[34],"\u22652":[35],"ARE.":[36],"A":[37,60],"total":[38,61],"of":[39,62,149,158,163,168,186],"324":[40],"were":[42,66,93],"allocated":[43],"by":[44],"outcome-stratified":[45],"random":[46],"sampling":[47],"(7:3)":[48],"training":[51],"set":[52,58],"(n=228)":[53],"held-out":[56,127,138],"test":[57,139],"(n=96).":[59],"six":[63],"consensus":[64],"predictors":[65],"retained:":[67],"Pre-existing":[68],"pruritus,":[69],"histological":[70,192],"grade,":[71,193],"body":[72],"mass":[73],"index":[74],"(BMI),":[75],"diabetes,":[76],"tumor":[77],"laterality":[78],"the":[80,106,111,137,146,198,214],"relative":[81,177],"esophageal":[82],"volume":[83],"\u226530":[85],"Gy":[86],"(RV_V30).":[87],"In":[88,136],"total,":[89],"10":[90],"ML":[91],"algorithms":[92],"evaluated.":[94],"Bootstrap":[95],"internal":[96],"validation":[97,235],"(1,000":[98],"resamples)":[99],"revealed":[100,173],"that":[101,218],"logistic":[102],"regression":[103],"(LR)":[104],"had":[105],"lowest":[107],"mean":[108],"optimism":[109],"among":[110],"three":[112],"preferred":[113],"candidates":[114],"(0.027).":[115],"Final":[116],"selection":[118],"considered":[119],"bootstrap":[120],"stability":[121],"corrected":[123],"performance":[124],"together":[125],"discrimination":[128],"calibration,":[130],"complexity":[132],"clinical":[134,240],"interpretability.":[135],"set,":[140],"LR":[141],"achieved":[142],"area":[144],"under":[145],"curve":[147,171],"value":[148],"0.797":[150],"(95%":[151],"confidence":[152],"interval,":[153],"0.706-0.889),":[154],"Brier":[156],"score":[157],"0.179,":[159],"calibration":[161],"slope":[162],"1.258":[164],"calibration-in-the-large":[167],"-0.056.":[169],"Decision":[170],"analysis":[172],"positive":[174],"net":[175],"benefit":[176],"treat-all":[179],"treat-none":[181],"strategies":[182],"across":[183],"threshold":[184],"probabilities":[185],"10-66%.":[187],"SHapley":[188],"Additive":[189],"exPlanations":[190],"identified":[191],"RV_V30":[194],"BMI":[196],"as":[197,207],"most":[199],"influential":[200],"predictors.":[201],"final":[203],"was":[205],"implemented":[206],"nomogram":[209],"web-based":[211],"calculator.":[212],"Overall,":[213],"demonstrates":[217],"this":[219],"six-feature":[220],"clinical-dosimetric":[221],"may":[223],"support":[224],"individualized":[225],"risk":[226],"stratification":[227],"radiotherapy":[229],"planning,":[230],"but":[231],"prospective":[232],"multicenter":[233],"external":[234],"required":[237],"before":[238],"routine":[239],"use.":[241]},"counts_by_year":[],"updated_date":"2026-11-01T11:40:01.658920","created_date":"2026-10-17T00:00:00"}