Tocicity of Neoadjuvant chemotherapy
Work in progress
https://rpubs.com/alex_istrate/534380
1 Pre-analysis
2 Abstract
We included 58 patients, of which 22 (37.9%) received neoadjuvant chemotherapy (NAC, 2 to 6 cycles, median=4). Patients stage ranged from IB to IVB with most common IIIB in NAC and IIB in controls (Mann-Whitney p<0.001). Stage is significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=0.50, p<0.001).
NAC patients received chemotherapy doses ranging from 30 to 40 (median=40) mg/mp, lower than controls (20 to 100, median=40, p=0.027). NAC patients received a statistically similar median number of chemotherapy cycles (2, ranging from 1 to 5) as the controls (3, 1 to 5, p=0.080). NAC patients lost significalnty more of their planned cycles compared to controls (0 to 4, median=3 vs. 0 to 2, median=1, p<0.001). NAC patients received significantly less total chemotherapy (expresed as a fraction of the total planned number of cycles), compared to controls (20% to 100%, median=40%, vs 50% to 100%, median=80%, p<0.001). The total chemotherapy cycles received are significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=-0.610, p<0.001). However, NAC patients received a statisitcaly similar total chemotherapy (expresed as a fraction of the total planned dose) compared to controls (75% to 101%, median=93%, vs 63% to 100%, median=93%, p=0.086). The total chemotherapy received is not significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=-0.045, p=0.739).
Toxicity was measured by blood cell counts, hemoglobin and creatinin measurements and urinary and digestive toxicity.
2.1 Leucocytes
NAC patients showed insignifficant toxicity by leucocyte counts (median=2460, 850:6310 vs median=2565, 1080:5600, p=0.466) as well as grade of leucopenia (p=0.719).
Lowest leucocyte count is not significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=-0.157, p=0.238), even after adjuting for total chemotherapy received (RSpearman=-0.160, p=0.233), but showed an increased correlation after adjuting for stage (RSpearman=-0.300, p=0.023).
On average, every additional neadjuvant chemotherapy cycle decreased the neutrophile count by 59.68 ±75.04 cells/mL (non significant). After adjusting for total chemotherapy received the average WBC count decreased by 65.07 ±74.39 cells/mL (non significant) and after adjusting for stage, the average neutrophile count decreased by 163.97 ±83.22 cells/mL. When adjusting for both at the same time, the average neutrophile count decreased by 187.06 * ±81.65 cells/mL.
There is a high degree of similarity between the Lowest Neutrophile count and the Lowest Leucocyte count (R=0.93***, the same as Lin’s CCC on standardized data) which explains the similarity of the results involving these two measurements and suggests that leucocyte toxicity is primarly based on neutrophiles.
2.2 Neutrophiles
NAC patients showed insignifficant toxicity by neutrophiles counts (median=1520, 720:5190 vs median=1900, 610:3970, p=0.340) as well as grade of neutropenia (p=0.617).
Lowest Neutrophile count is not significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=-0.175, p=0.190), even after adjuting for total chemotherapy received (RSpearman=-0.182, p=0.176), but showed a stronger correlation after adjuting for stage (RSpearman=-0.316, p=0.017).
On average, every additional neadjuvant chemotherapy cycle decreased the neutrophile count by 57.84 ±65.97 cells/mL (non significant). After adjusting for total chemotherapy received the average neutrophile count decreased by 63.62 ±64.78 cells/mL (non significant) but after adjusting for stage, the average neutrophile count decreased by 162.4 * ±71.93 cells/mL. When adjusting for both at the same time, the average neutrophile count increased by 186.79 ** ±69.19 cells/mL.
2.3 Lymphocytes
NAC patients showed insignifficant toxicity by lymphocyte counts (median=405, 70:950 vs median=365, 150:660, p=0.251) as well as grade of lymphopenia (p=0.594).
Lowest lymphocyte count is not significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=0.132, p=0.323), even after adjuting for total chemotherapy received (RSpearman=0.131, p=0.331) nor after adjuting for stage (RSpearman=0.231, p=0.084).
On average, every additional neadjuvant chemotherapy cycle increased the lymphocyte count by 5.19 ±9.58 cells/mL (non significant). After adjusting for total chemotherapy received the average lymphocyte count increased by 5.36 ±9.67 cells/mL (non significant) and after adjusting for stage, the average lymphocyte count increased by 15.45 ±10.87 cells/mL (non significant). When adjusting for both at the same time, the average lymphocyte count decreased by 16.55 ±11.02 cells/mL (non significant).
2.4 Platelets
NAC patients showed signifficantly more toxicity by platelet counts (median=126.5, 29:271 vs median=153.5, 56:462, p=0.025) but not by grade of thrombocytopenia (p=0.685).
Lowest platelet count is significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=-0.423, p=0.003), even after adjuting for total chemotherapy received (RSpearman=-0.249, p=0.091) and after adjuting for stage (RSpearman=-0.419, p=0.003).
On average, every additional neadjuvant chemotherapy cycle decreased the platelet count by 14.11** ±5.1 cells/mL. After adjusting for total chemotherapy received the average platelet count decreased by 14.41* ±6.3 cells/mL and after adjusting for stage, the average platelet count decreased by 17.85** ±6.0 cells/mL. When adjusting for both at the same time, the average platelet count decreased by 18.79* ±7.3 cells/mL.
2.5 Hemoglobin
NAC patients showed signifficantly lower hemoglobin (median=10.15, 7.6:12.9 vs median=11.25, 8.2:13.4, p=0.004) but not a higher grade of anemia (p=0.128).
Lowest hemoglobin level is significantly correlated with the number of neoadjuvant chemotherapy cycles (RSpearman=-0.406, p=0.002), even after adjuting for total chemotherapy received (RSpearman=-0.415, p=0.001). After adjuting for stage, the partial correlation only showed a tendency towards statisatical significance (RSpearman=-0.257, p=0.054).
On average, every additional neadjuvant chemotherapy cycle decreased the hemoglobin level by 0.25 ** ±0.08 cells/mL. After adjusting for total chemotherapy received the average hemoglobin level decreased by 0.26 ** ±0.08 cells/mL and after adjusting for stage, the average hemoglobin level decreased by 0.16 ±0.09 cells/mL (not significant). When adjusting for both at the same time, the average hemoglobin level decreased by 0.17 ±0.9 cells/mL (not significant).
2.6 Other toxicities
Elevated creatinin levels were found in 9.1% of the NAC patients and 11.1% of the control patients (OR=1.25 [0.21, 7.46. p=1.000). Among cases, 36.4% had registered urinary toxicity grade 1 (none with grade 2) while among controls 25.0% had toxicity grade 1 and another patient had grade 2 (OR=1.71 [0.54, 5.42], p=0.387).
Digestive toxicity grade > 0 were found in 72.7% on the NAT patients (with 3 patients - 13.6% grade 2 and 1 patient - 4.5% grade 3) and 58.3% (with 5 patients - 13.9% grade 2) of the control patients (p=0.439). RT was given to Lombo-aortics in 45.5% of the NAC patients and 13.9% of the control patinents (OR=5.17 [1.46, 18.28], p=0.013).
3 Results
Table 1: All recorded paramenters of the paticipants, for each treatment group.
Factor | Detalis | Total | NAC | Control | Statistics |
Group | 58 | 22 (37.9%) | 36 (62.1%) | ||
Neoadjuvant chemotherapy cycles | μ ±DS | 1.45 ±1.95 | 3.82 ±0.907 | 0.00 ±0.0 | MW: p<0.001 |
M (min:max) | 0 (0:6) | 4 (2:6) | 0 (0:0) | ||
Age at diagnosis (years) | μ ±DS | 53.37 ±10.5 | 53.59 ±11.2 | 53.23 ±10.3 | T-test: p=0.901 |
M (min:max) | 53 (29:72) | 53.5 (29:71) | 51 (36:72) | ||
Stage | IB | 1 (1.7%) | 0 | 1 (2.8%) | V=0.50 (p=0.013) |
IIA | 1 (1.7%) | 0 | 1 (2.8%) | ||
IIB | 28 (48.3%) | 5 (22.7%) | 23 (63.9%) | ||
IIIA | 0 | 0 | 0 | ||
IIIB | 19 (32.8%) | 10 (45.5%) | 9 (25.0%) | ||
IVA | 7 (12.1%) | 5 (22.7%) | 2 (5.6%) | ||
IVB | 2 (3.4%) | 2 (9.1%) | 0 | ||
Stage (numeric) | μ ±DS | 3.05 ±0.68 | 3.48 ±0.626 | 2.79 ±0.578 | MW: p<0.001 |
M (min:max) | 2.5 (1.5:4.5) | 3.5 (2.5:4.5) | 2.5 (1.5:4) | ||
Dose used | Cis 30mg/m² | 6 (10.3%) | 3 (13.6%) | 3 (8.3%) | V=0.46 (p=0.002) |
Cis 40mg/m² | 37 (63.8%) | 19 (86.4%) | 18 (50.0%) | ||
Cis 100mg/m² | 15 (25.9%) | 0 | 15 (41.7%) | ||
Cis dose (mg/m²) | μ ±DS | 54.48 ±27.3 | 38.64 ±3.51 | 64.17 ±30.8 | MW: p=0.002 |
M (min:max) | 40 (30:100) | 40 (30:40) | 40 (30:100) | ||
Concomitant chemotherapy cycles | μ ±DS | 2.59 ±1.2 | 2.23 ±1.02 | 2.81 ±1.26 | MW: p=0.080 |
M (min:max) | 2 (1:5) | 2 (1:5) | 3 (1:5) | ||
Lost cycles | μ ±DS | 1.59 ±1.28 | 2.77 ±1.02 | 0.861 ±0.798 | MW: p<0.001 |
M (min:max) | 1.5 (0:4) | 3 (0:4) | 1 (0:2) | ||
Concomitant chemotherapy | μ ±DS | 0.652 ±0.259 | 0.445 ±0.204 | 0.778 ±0.203 | MW: p<0.001 |
M (min:max) | 0.6 (0.2:1) | 0.4 (0.2:1) | 0.8 (0.5:1) | ||
Chemotherapy received (%) | μ ±DS | 0.907 ±0.0783 | 0.905 ±0.0734 | 0.908 ±0.0821 | MW: p=0.860 |
M (min:max) | 0.92 (0.63:1.01) | 0.92 (0.75:1.01) | 0.93 (0.63:1) | ||
Lowest Leucocyte count | μ ±DS | 2762.76 ±1100.1 | 2670.45 ±1166.5 | 2819.17 ±1070.5 | MW: p=0.466 |
M (min:max) | 2505 (850:6310) | 2460 (850:6310) | 2565 (1080:5600) | ||
Leucopenia grade | 0 | 7 (12.1%) | 2 (9.1%) | 5 (13.9%) | V=0.19 (p=0.719) |
1 | 11 (19.0%) | 4 (18.2%) | 7 (19.4%) | ||
2 | 25 (43.1%) | 9 (40.9%) | 16 (44.4%) | ||
3 | 14 (24.1%) | 6 (27.3%) | 8 (22.2%) | ||
4 | 1 (1.7%) | 1 (4.5%) | 0 | ||
Lowest Neutrophile count | μ ±DS | 1964.40 ±968.4 | 1854.77 ±1056.2 | 2031.39 ±919.7 | MW: p=0.340 |
M (min:max) | 1767.5 (610:5190) | 1520 (720:5190) | 1900 (610:3970) | ||
Neutropenia grade | 0 | 21 (36.2%) | 6 (27.3%) | 15 (41.7%) | V=0.18 (p=0.617) |
1 | 14 (24.1%) | 5 (22.7%) | 9 (25.0%) | ||
2 | 15 (25.9%) | 7 (31.8%) | 8 (22.2%) | ||
3 | 8 (13.8%) | 4 (18.2%) | 4 (11.1%) | ||
Lowest Lymphocyte count | μ ±DS | 379.50 ±140.1 | 405.00 ±166.9 | 363.92 ±120.8 | MW: p=0.251 |
M (min:max) | 390 (70:950) | 405 (70:950) | 365 (150:660) | ||
Lymphopenia grade | 1 | 1 (1.7%) | 1 (4.5%) | 0 | V=0.18 (p=0.594) |
2 | 8 (13.8%) | 3 (13.6%) | 5 (13.9%) | ||
3 | 42 (72.4%) | 16 (72.7%) | 26 (72.2%) | ||
4 | 7 (12.1%) | 2 (9.1%) | 5 (13.9%) | ||
Lowest Platelet count | μ ±DS | 157.41 ±73.7 | 130.91 ±56.5 | 173.61 ±78.9 | MW: p=0.025 |
M (min:max) | 146 (29:462) | 126.5 (29:271) | 153.5 (56:462) | ||
Thrombocytopenia grade | 0 | 49 (84.5%) | 18 (81.8%) | 31 (86.1%) | V=0.16 (p=0.685) |
1 | 4 (6.9%) | 1 (4.5%) | 3 (8.3%) | ||
2 | 2 (3.4%) | 1 (4.5%) | 1 (2.8%) | ||
3 | 3 (5.2%) | 2 (9.1%) | 1 (2.8%) | ||
Lowest Hemoglobin | μ ±DS | 10.74 ±1.24 | 10.15 ±1.06 | 11.10 ±1.22 | T-test: p=0.004 |
M (min:max) | 10.8 (7.6:13.4) | 10.15 (7.6:12.9) | 11.25 (8.2:13.4) | ||
Anemia grade | 0 | 9 (15.5%) | 1 (4.5%) | 8 (22.2%) | V=0.31 (p=0.128) |
1 | 37 (63.8%) | 14 (63.6%) | 23 (63.9%) | ||
2 | 11 (19.0%) | 6 (27.3%) | 5 (13.9%) | ||
3 | 1 (1.7%) | 1 (4.5%) | 0 | ||
Creatinine level | normal | 52 (89.7%) | 20 (90.9%) | 32 (88.9%) | OR=1.25 [0.21, 7.46] (p=1.000) |
elevated | 6 (10.3%) | 2 (9.1%) | 4 (11.1%) | ||
Urinary toxicity | 17 (29.3%) | 8 (36.4%) | 9 (25.0%) | OR=1.71 [0.54, 5.42] (p=0.387) | |
Digestive toxicity | 0 | 21 (36.2%) | 6 (27.3%) | 15 (41.7%) | V=0.22 (p=0.439) |
1 | 28 (48.3%) | 12 (54.5%) | 16 (44.4%) | ||
2 | 8 (13.8%) | 3 (13.6%) | 5 (13.9%) | ||
3 | 1 (1.7%) | 1 (4.5%) | 0 | ||
Radiotherapy duration (days) | μ ±DS | 38.78 ±6.8 | 41.91 ±10.0 | 36.86 ±2.28 | MW: p=0.035 |
M (min:max) | 37 (31:72) | 38 (32:72) | 37 (31:42) | ||
Fractination used | 50.4/28 | 41 (70.7%) | 16 (72.7%) | 25 (69.4%) | OR=1.17 [0.36, 3.80] (p=1.000) |
45/25 | 17 (29.3%) | 6 (27.3%) | 11 (30.6%) | ||
Radiotherapy to lombo-aortics | 15 (25.9%) | 10 (45.5%) | 5 (13.9%) | OR=5.17 [1.46, 18.28] (p=0.013) | |
Simultaneous integrated boost (SIB) | 30 (52.6%) | 13 (61.9%) | 17 (47.2%) | OR=1.82 [0.61, 5.44] (p=0.410) | |
Sequential Boost instead of SIB | 9 (15.5%) | 6 (27.3%) | 3 (8.3%) | OR=4.12 [0.91, 18.66] (p=0.070) | |
Brachytherapy fractions | μ ±DS | 2.74 ±1.54 | 2.57 ±1.6 | 2.83 ±1.52 | MW: p=0.480 |
M (min:max) | 4 (0:4) | 3 (0:4) | 4 (0:4) | ||
μ ±DS = Mean (standard deviation); M (min:max) = Median (min:max); MW = Mann-WhitneyTest; OR/RR = odds-ratio / risc-ratio [95% CI] and p value from Fisher test); V = Cramer V (p value from Chi² test); | |||||
3.1 NAC ~ Stage
Figure 1: Correlation between Stage and the number of NaC cycles. Size reprezents number of patients. Boxplot by group. Control: no NAC cycles. In NAC cases, median and IQR are at the IIIB level.
3.2 NAC ~ Total chemotherapy received (fraction of planned total cycles)
Figure 2: Correlation between Total chemotherapy received (fraction of planned total cycles) and the number of NaC cycles. Size reprezents number of patients. Boxplot by group. Control: no NAC cycles.
3.3 NAC ~ Total chemotherapy received (fraction of planned total dose)
Figure 3: Correlation between DT Chimio Administrat / Recom (%) (fraction of planned total dose) and the number of NaC cycles. Size reprezents number of patients. Boxplot by group. Control: no NAC cycles.
3.4 NAC ~ Leucocytes
Figure 4: Correlation between Lowest Leucocyte count and the number of NaC cycles. Grade of Leucopenia highlighted. Boxplot by group. Control: no NAC cycles. Clinical Leucocyte tresholds marked by dotted blue line.
| simple | chemo | stage | interaction | full | extended | |
|---|---|---|---|---|---|---|
| Lowest Leucocyte count BY: | Estimates | Estimates | Estimates | Estimates | Estimates | Estimates |
| (intercept) | 2849.19 *** (181.14) | 5303.92 ** (1694.42) | 1195.72 (689.02) | 2077.08 ** (622.24) | 4259.14 * (1632.16) | 2237.81 (3061.00) |
| Neoadjuvant chemotherapy cycles | -59.68 (75.04) | -65.07 (74.39) | -163.97 (83.22) | -104.91 (82.34) | -187.06 * (81.65) | -193.30 (124.42) |
| Chemotherapy received (%) | -2697.75 (1851.71) | -3642.38 * (1769.79) | -2264.14 (2189.79) | |||
| Stage (numeric) | 591.31 * (238.48) | 681.01 ** (235.82) | 538.63 (322.54) | |||
| (interaction) | 301.84 (232.85) | |||||
| Age at diagnosis (years) | -1.46 (16.41) | |||||
| Cis dose (mg/m²) | -6.93 (6.96) | |||||
| Concomitant chemotherapy cycles received (%) | 647.87 (800.56) | |||||
| Radiotherapy duration (days) | 38.91 (47.21) | |||||
| Fractination used: 45/25 vs. 50.4/28 | -522.62 (388.81) | |||||
| Simultaneous integrated boost (SIB) | 273.94 (382.46) | |||||
| Radiotherapy to lombo-aortics | 89.51 (422.74) | |||||
| Sequential Boost instead of SIB | -378.59 (596.90) | |||||
| Brachytherapy fractions | 2.83 (113.26) | |||||
| Observations | 58 | 58 | 58 | 58 | 58 | 55 |
| R2 / R2 adjusted | 0.011 / -0.006 | 0.048 / 0.013 | 0.111 / 0.078 | 0.040 / 0.006 | 0.175 / 0.129 | 0.236 / 0.018 |
| AIC | 981.306 | 981.110 | 977.160 | 981.560 | 974.780 | 940.780 |
|
||||||
R | Simple | Chemo | Stage | Interaction |
Pearson | -0.106 | -0.117 | -0.257 | -0.169 |
(p) | p=0.430 | p=0.386 | p=0.054 | p=0.208 |
Spearman | -0.157 | -0.160 | -0.300 | -0.237 |
(p) | p=0.238 | p=0.233 | p=0.023 | p=0.077 |
Figure 5: Correlation between Lowest Leucocyte count and the number of NaC cycles by Stage (left) and Chemotherapy received as a fraction of planned total dose (right). Clinical tresholds marked by dotted blue line. Statistics depict the Pearson correlation coefficient (with p-value) for the raw relation, the partial corelation by each covariate (with p-value) and the adjusted R² of a regression model with each covariate (with model F-statistic’s p-value).
Error in optim(s0, fmin, gmin, method = “BFGS”, …) : initial value in ‘vmmin’ is not finite
Table 3: Ordinal logistic regression models of Leucopenia grade by number of NaC cycles unadjusted and adjusted for chemotherapy receiced, stage and several other variables.
Factor: OR | extended | full | interaction | chemo | stage | simple |
0|1 | <0.001 | 0.306 | 0.019 *** | 2.322 | 0.004 *** | 0.166 *** |
1|2 | 0.003 | 1.21 | 0.065 * | 7.753 | 0.014 ** | 0.549 ⁺ |
2|3 | 0.03 | 11.162 | 0.494 | 51.618 | 0.118 ⁺ | 3.616 *** |
3|4 | 0.791 | 265.83 ⁺ | 10.996 ⁺ | >1000 * | 2.799 | 74.494 *** |
Neoadjuvant chemotherapy cycles | 1.41 [0.909, 2.242] | 1.535 ** [1.126, 2.128] | 1.333 ⁺ [1.002, 1.791] | 1.164 [0.899, 1.513] | 1.477 * [1.092, 2.028] | 1.169 |
Chemotherapy received (%) | 12.083 [0.005, >1000] | 244.444 [0.291, >1000] | 18.508 [0.023, >1000] | |||
Stage (numeric) | 0.353 ⁺ [0.113, 1.07] | 0.233 ** [0.09, 0.57] | 0.278 ** [0.112, 0.659] | |||
(interaction) | 0.445 * [0.197, 0.98] | |||||
Age at diagnosis (years) | 0.998 [0.943, 1.056] | |||||
Cis dose (mg/m²) | 1.012 [0.989, 1.036] | |||||
Concomitant chemotherapy | 0.11 [0.006, 1.785] | |||||
Radiotherapy duration (days) | 0.915 [0.78, 1.064] | |||||
Fractination used: 45/25 vs. 50.4/28 | 1.698 [0.886, 3.339] | |||||
Simultaneous integrated boost (SIB) | 0.773 [0.411, 1.432] | |||||
Radiotherapy to lombo-aortics | 1.014 [0.488, 2.122] | |||||
Sequential Boost instead of SIB | 1.341 [0.497, 3.753] | |||||
Brachytherapy fractions | 1.002 [0.694, 1.44] | |||||
McFadden's pseudo-R² | 0.158 | 0.08 | 0.035 | 0.014 | 0.064 | 0.009 |
AIC | 163.4 | 157.7 | 162.7 | 166.0 | 158.2 | 164.8 |
3.5 NAC ~ Neutrophiles
Figure 6: Correlation between Lowest Neutrophile count and the number of NaC cycles. Grade of Neutropenia highlighted. Boxplot by group. Control: no NAC cycles. Clinical Neutrophile tresholds marked by dotted blue line.
| simple | chemo | stage | interaction | full | extended | |
|---|---|---|---|---|---|---|
| Lowest Neutrophile count BY: | Estimates | Estimates | Estimates | Estimates | Estimates | Estimates |
| (intercept) | 2048.17 *** (159.26) | 4680.77 ** (1475.65) | 390.42 (595.53) | 1272.53 * (544.52) | 3625.92 * (1383.15) | 2307.82 (2497.98) |
| Neoadjuvant chemotherapy cycles | -57.84 (65.97) | -63.62 (64.78) | -162.40 * (71.93) | -103.28 (72.06) | -186.79 ** (69.19) | -218.19 * (101.54) |
| Chemotherapy received (%) | -2893.24 (1612.63) | -3846.98 * (1499.78) | -2536.45 (1787.01) | |||
| Stage (numeric) | 592.84 ** (206.12) | 687.58 ** (199.84) | 593.58 * (263.22) | |||
| (interaction) | 303.22 (203.76) | |||||
| Age at diagnosis (years) | -10.09 (13.39) | |||||
| Cis dose (mg/m²) | -10.16 (5.68) | |||||
| Concomitant chemotherapy cycles received (%) | 569.58 (653.31) | |||||
| Radiotherapy duration (days) | 37.71 (38.53) | |||||
| Fractination used: 45/25 vs. 50.4/28 | -472.95 (317.29) | |||||
| Simultaneous integrated boost (SIB) | 209.94 (312.11) | |||||
| Radiotherapy to lombo-aortics | 19.23 (344.99) | |||||
| Sequential Boost instead of SIB | -400.60 (487.11) | |||||
| Brachytherapy fractions | 3.64 (92.43) | |||||
| Observations | 58 | 58 | 58 | 58 | 58 | 55 |
| R2 / R2 adjusted | 0.014 / -0.004 | 0.068 / 0.034 | 0.143 / 0.111 | 0.052 / 0.017 | 0.236 / 0.193 | 0.330 / 0.139 |
| AIC | 966.372 | 965.074 | 960.246 | 966.083 | 955.577 | 918.421 |
|
||||||
R | Simple | Chemo | Stage | Interaction |
Pearson | -0.116 | -0.131 | -0.291 | -0.190 |
(p) | p=0.384 | p=0.330 | p=0.028 | p=0.157 |
Spearman | -0.175 | -0.182 | -0.316 | -0.239 |
(p) | p=0.190 | p=0.176 | p=0.017 | p=0.073 |
Figure 7: Correlation between Lowest Neutrophile count and the number of NaC cycles by Stage (left) and Chemotherapy received as a fraction of planned total dose (right). Clinical tresholds marked by dotted blue line. Statistics depict the Pearson correlation coefficient (with p-value) for the raw relation, the partial corelation by each covariate (with p-value) and the adjusted R² of a regression model with each covariate (with model F-statistic’s p-value).
0 1 2 3 21 14 15 8 Error in optim(s0, fmin, gmin, method = “BFGS”, …) : initial value in ‘vmmin’ is not finite
Table 5: Ordinal logistic regression models of Neutropenia grade by number of NaC cycles unadjusted and adjusted for chemotherapy receiced, stage and several other variables.
Factor: OR | extended | full | interaction | chemo | stage | simple |
0|1 | 0.002 | 0.409 | 0.059 * | 6.296 | 0.013 ** | 0.747 |
1|2 | 0.007 | 1.421 | 0.182 | 17.615 | 0.045 * | 2.077 * |
2|3 | 0.042 | 6.977 | 0.851 | 76.529 | 0.219 | 9.023 *** |
Neoadjuvant chemotherapy cycles | 1.875 ** [1.183, 3.08] | 1.716 ** [1.237, 2.441] | 1.505 ** [1.113, 2.072] | 1.23 [0.954, 1.595] | 1.692 ** [1.223, 2.404] | 1.238 |
Chemotherapy received (%) | 1.82 [<0.001, >1000] | 60.517 [0.094, >1000] | 10.578 [0.021, >1000] | |||
Stage (numeric) | 0.162 ** [0.044, 0.531] | 0.207 ** [0.074, 0.528] | 0.229 ** [0.084, 0.57] | |||
(interaction) | 0.359 * [0.146, 0.835] | |||||
Age at diagnosis (years) | 1.016 [0.957, 1.08] | |||||
Cis dose (mg/m²) | 1.026 * [1.001, 1.054] | |||||
Concomitant chemotherapy | 0.178 [0.008, 3.479] | |||||
Radiotherapy duration (days) | 0.929 [0.785, 1.096] | |||||
Fractination used: 45/25 vs. 50.4/28 | 1.726 [0.851, 3.674] | |||||
Simultaneous integrated boost (SIB) | 1.214 [0.615, 2.412] | |||||
Radiotherapy to lombo-aortics | 1.261 [0.596, 2.724] | |||||
Sequential Boost instead of SIB | 1.493 [0.525, 4.169] | |||||
Brachytherapy fractions | 1.125 [0.754, 1.675] | |||||
McFadden's pseudo-R² | 0.214 | 0.094 | 0.054 | 0.021 | 0.084 | 0.018 |
AIC | 151.7 | 152.2 | 156.3 | 161.4 | 151.7 | 160.0 |
3.6 NAC ~ Lymphocytes
Figure 6: Correlation between Lowest Neutrophile count and the number of NaC cycles. Grade of Neutropenia highlighted. Boxplot by group. Control: no NAC cycles. Clinical Neutrophile tresholds marked by dotted blue line.
| simple | chemo | stage | interaction | full | extended | |
|---|---|---|---|---|---|---|
| Lowest Lymphocyte count BY: | Estimates | Estimates | Estimates | Estimates | Estimates | Estimates |
| (intercept) | 371.99 *** (23.14) | 292.85 (220.30) | 534.77 *** (89.98) | 489.84 *** (78.95) | 388.72 (220.27) | -221.50 (383.62) |
| Neoadjuvant chemotherapy cycles | 5.19 (9.58) | 5.36 (9.67) | 15.45 (10.87) | 12.09 (10.45) | 16.55 (11.02) | 12.96 (15.59) |
| Chemotherapy received (%) | 86.97 (240.74) | 173.65 (238.84) | 399.65 (274.44) | |||
| Stage (numeric) | -58.21 (31.14) | -62.49 (31.83) | -35.72 (40.42) | |||
| (interaction) | -46.07 (29.55) | |||||
| Age at diagnosis (years) | 2.87 (2.06) | |||||
| Cis dose (mg/m²) | 0.14 (0.87) | |||||
| Concomitant chemotherapy cycles received (%) | -48.57 (100.33) | |||||
| Radiotherapy duration (days) | 7.80 (5.92) | |||||
| Fractination used: 45/25 vs. 50.4/28 | -61.26 (48.73) | |||||
| Simultaneous integrated boost (SIB) | -10.39 (47.93) | |||||
| Radiotherapy to lombo-aortics | -66.06 (52.98) | |||||
| Sequential Boost instead of SIB | -77.38 (74.81) | |||||
| Brachytherapy fractions | -7.67 (14.19) | |||||
| Observations | 58 | 58 | 58 | 58 | 58 | 55 |
| R2 / R2 adjusted | 0.005 / -0.013 | 0.008 / -0.029 | 0.065 / 0.031 | 0.047 / 0.013 | 0.074 / 0.022 | 0.227 / 0.007 |
| AIC | 742.592 | 744.455 | 741.020 | 742.083 | 742.455 | 712.328 |
|
||||||
R | Simple | Chemo | Stage | Interaction |
Pearson | 0.072 | 0.075 | 0.188 | 0.154 |
(p) | p=0.591 | p=0.582 | p=0.161 | p=0.252 |
Spearman | 0.132 | 0.131 | 0.231 | 0.201 |
(p) | p=0.323 | p=0.331 | p=0.084 | p=0.134 |
Figure 8: Correlation between Lowest Lymphocyte count and the number of NaC cycles by Stage (left) and Chemotherapy received as a fraction of planned total dose (right). Clinical tresholds marked by dotted blue line. Statistics depict the Pearson correlation coefficient (with p-value) for the raw relation, the partial corelation by each covariate (with p-value) and the adjusted R² of a regression model with each covariate (with model F-statistic’s p-value).
Error in optim(s0, fmin, gmin, method = “BFGS”, …) : initial value in ‘vmmin’ is not finite
Table 7: Ordinal logistic regression models of Lymphopenia grade by number of NaC cycles unadjusted and adjusted for chemotherapy receiced, stage and several other variables.
Factor: OR | extended | full | interaction | chemo | stage | simple |
1|2 | <0.001 * | 0.002 ⁺ | 0.032 * | 0.001 ⁺ | 0.057 ⁺ | 0.016 *** |
2|3 | <0.001 ⁺ | 0.024 | 0.333 | 0.012 | 0.593 | 0.173 *** |
3|4 | <0.001 | 1.061 | 13.503 * | 0.476 | 24.694 * | 6.88 *** |
Neoadjuvant chemotherapy cycles | 0.91 [0.543, 1.535] | 0.864 [0.609, 1.215] | 0.925 [0.672, 1.273] | 0.953 [0.711, 1.276] | 0.89 [0.634, 1.245] | 0.96 |
Chemotherapy received (%) | <0.001 [<0.001, 10.342] | 0.022 [<0.001, 34.826] | 0.052 [<0.001, 68.972] | |||
Stage (numeric) | 0.741 [0.183, 2.875] | 1.755 [0.635, 4.97] | 1.564 [0.582, 4.281] | |||
(interaction) | 1.296 [0.517, 3.26] | |||||
Age at diagnosis (years) | 0.949 [0.882, 1.015] | |||||
Cis dose (mg/m²) | 1 [0.97, 1.031] | |||||
Concomitant chemotherapy | 4.25 [0.155, 148.26] | |||||
Radiotherapy duration (days) | 0.927 [0.763, 1.121] | |||||
Fractination used: 45/25 vs. 50.4/28 | 1.048 [0.455, 2.392] | |||||
Simultaneous integrated boost (SIB) | 1.282 [0.57, 2.937] | |||||
Radiotherapy to lombo-aortics | 2.047 [0.808, 5.654] | |||||
Sequential Boost instead of SIB | 1.818 [0.531, 6.516] | |||||
Brachytherapy fractions | 1.18 [0.743, 1.898] | |||||
McFadden's pseudo-R² | 0.209 | 0.02 | 0.004 | 0.007 | 0.009 | 0.001 |
AIC | 106.3 | 106.6 | 106.1 | 105.8 | 105.7 | 104.5 |
3.7 NAC ~ Platelets
Figure 6: Correlation between Lowest Neutrophile count and the number of NaC cycles. Grade of Neutropenia highlighted. Boxplot by group. Control: no NAC cycles. Clinical Neutrophile tresholds marked by dotted blue line.
| simple | chemo | stage | interaction | full | extended | |
|---|---|---|---|---|---|---|
| Lowest Platelet count BY: | Estimates | Estimates | Estimates | Estimates | Estimates | Estimates |
| (intercept) | 172.35 *** (11.75) | 75.83 (111.21) | 148.50 ** (46.99) | 144.62 *** (40.77) | 66.43 (114.95) | 39.93 (206.13) |
| Neoadjuvant chemotherapy cycles | -10.32 * (4.87) | -10.10 * (4.88) | -11.82 * (5.68) | -11.94 * (5.40) | -11.20 (5.75) | -10.41 (8.38) |
| Chemotherapy received (%) | 106.08 (121.53) | 97.58 (124.64) | 91.64 (147.46) | |||
| Stage (numeric) | 8.53 (16.27) | 6.13 (16.61) | -9.18 (21.72) | |||
| (interaction) | 10.84 (15.26) | |||||
| Age at diagnosis (years) | -1.43 (1.11) | |||||
| Cis dose (mg/m²) | 0.44 (0.47) | |||||
| Concomitant chemotherapy cycles received (%) | -18.42 (53.91) | |||||
| Radiotherapy duration (days) | 4.48 (3.18) | |||||
| Fractination used: 45/25 vs. 50.4/28 | -12.56 (26.18) | |||||
| Simultaneous integrated boost (SIB) | 7.86 (25.75) | |||||
| Radiotherapy to lombo-aortics | -2.15 (28.47) | |||||
| Sequential Boost instead of SIB | -38.47 (40.20) | |||||
| Brachytherapy fractions | -7.10 (7.63) | |||||
| Observations | 58 | 58 | 58 | 58 | 58 | 55 |
| R2 / R2 adjusted | 0.074 / 0.058 | 0.087 / 0.054 | 0.079 / 0.045 | 0.083 / 0.049 | 0.089 / 0.039 | 0.233 / 0.014 |
| AIC | 663.959 | 665.161 | 665.670 | 665.429 | 667.015 | 643.999 |
|
||||||
R | Simple | Chemo | Stage | Interaction |
Pearson | -0.273 | -0.269 | -0.270 | -0.286 |
(p) | p=0.038 | p=0.043 | p=0.042 | p=0.031 |
Spearman | -0.326 | -0.324 | -0.316 | -0.335 |
(p) | p=0.013 | p=0.014 | p=0.017 | p=0.011 |
Figure 9: Correlation between Lowest Platelet count and the number of NaC cycles by Stage (left) and Chemotherapy received as a fraction of planned total dose (right). Clinical tresholds marked by dotted blue line. Statistics depict the Pearson correlation coefficient (with p-value) for the raw relation, the partial corelation by each covariate (with p-value) and the adjusted R² of a regression model with each covariate (with model F-statistic’s p-value).
Error in optim(s0, fmin, gmin, method = “BFGS”, …) : initial value in ‘vmmin’ is not finite
Table 9: Ordinal logistic regression models of Thrombocytopenia grade by number of NaC cycles unadjusted and adjusted for chemotherapy receiced, stage and several other variables.
Factor: OR | extended | full | interaction | chemo | stage | simple |
0|1 | >1000 | 81.545 | 17.55 ⁺ | 53.259 | 15.33 | 6.188 *** |
1|2 | >1000 | 159.073 | 34.237 * | 103.852 | 29.887 ⁺ | 12.059 *** |
2|3 | >1000 | 277.043 | 59.64 * | 180.483 | 51.959 * | 20.911 *** |
Neoadjuvant chemotherapy cycles | 1.421 [0.699, 3.036] | 1.042 [0.672, 1.58] | 1.028 [0.678, 1.517] | 1.095 [0.746, 1.561] | 1.03 [0.666, 1.553] | 1.089 |
Chemotherapy received (%) | 340.141 [<0.001, >1000] | 7.033 [<0.001, >1000] | 10.558 [<0.001, >1000] | |||
Stage (numeric) | 1.232 [0.125, 8.7] | 1.326 [0.377, 4.569] | 1.379 [0.401, 4.676] | |||
(interaction) | 1.494 [0.462, 4.817] | |||||
Age at diagnosis (years) | 1.251 ** [1.102, 1.508] | |||||
Cis dose (mg/m²) | 1.006 [0.959, 1.05] | |||||
Concomitant chemotherapy | 11.005 [0.088, >1000] | |||||
Radiotherapy duration (days) | 0.785 [0.539, 1.044] | |||||
Fractination used: 45/25 vs. 50.4/28 | 1.089 [0.327, 4.33] | |||||
Simultaneous integrated boost (SIB) | 1.399 [0.379, 6.816] | |||||
Radiotherapy to lombo-aortics | 2.562 [0.775, 10.179] | |||||
Sequential Boost instead of SIB | 1.227 [0.149, 8.64] | |||||
McFadden's pseudo-R² | 0.289 | 0.009 | 0.01 | 0.006 | 0.007 | 0.003 |
AIC | 77.2 | 80.5 | 78.5 | 78.7 | 78.7 | 76.9 |
3.8 NAC ~ Hemoglobin
Figure 6: Correlation between Lowest Neutrophile count and the number of NaC cycles. Grade of Neutropenia highlighted. Boxplot by group. Control: no NAC cycles. Clinical Neutrophile tresholds marked by dotted blue line.
| simple | chemo | stage | interaction | full | extended | |
|---|---|---|---|---|---|---|
| Lowest Hemoglobin BY: | Estimates | Estimates | Estimates | Estimates | Estimates | Estimates |
| (intercept) | 11.11 *** (0.19) | 13.29 *** (1.78) | 12.59 *** (0.73) | 12.49 *** (0.63) | 14.04 *** (1.78) | 13.51 *** (2.87) |
| Neoadjuvant chemotherapy cycles | -0.25 ** (0.08) | -0.26 ** (0.08) | -0.16 (0.09) | -0.17 * (0.08) | -0.17 (0.09) | -0.15 (0.12) |
| Chemotherapy received (%) | -2.40 (1.95) | -1.72 (1.93) | -0.69 (2.05) | |||
| Stage (numeric) | -0.53 * (0.25) | -0.49 (0.26) | -0.53 (0.30) | |||
| (interaction) | -0.54 * (0.24) | |||||
| Age at diagnosis (years) | -0.02 (0.02) | |||||
| Cis dose (mg/m²) | 0.01 (0.01) | |||||
| Concomitant chemotherapy cycles received (%) | -0.65 (0.75) | |||||
| Radiotherapy duration (days) | 0.06 (0.04) | |||||
| Fractination used: 45/25 vs. 50.4/28 | -0.42 (0.36) | |||||
| Simultaneous integrated boost (SIB) | -0.44 (0.36) | |||||
| Radiotherapy to lombo-aortics | 0.40 (0.40) | |||||
| Sequential Boost instead of SIB | -1.09 (0.56) | |||||
| Brachytherapy fractions | -0.30 ** (0.11) | |||||
| Observations | 58 | 58 | 58 | 58 | 58 | 55 |
| R2 / R2 adjusted | 0.154 / 0.139 | 0.177 / 0.147 | 0.217 / 0.189 | 0.228 / 0.200 | 0.228 / 0.185 | 0.454 / 0.297 |
| AIC | 185.143 | 185.566 | 182.671 | 181.837 | 183.830 | 173.741 |
|
||||||
R | Simple | Chemo | Stage | Interaction |
Pearson | -0.393 | -0.403 | -0.233 | -0.264 |
(p) | p=0.002 | p=0.002 | p=0.081 | p=0.047 |
Spearman | -0.406 | -0.415 | -0.257 | -0.293 |
(p) | p=0.002 | p=0.001 | p=0.054 | p=0.027 |
Figure 10: Correlation between Lowest Hemoglobin and the number of NaC cycles by Stage (left) and Chemotherapy received as a fraction of planned total dose (right). Clinical tresholds marked by dotted blue line. Statistics depict the Pearson correlation coefficient (with p-value) for the raw relation, the partial corelation by each covariate (with p-value) and the adjusted R² of a regression model with each covariate (with model F-statistic’s p-value).
Error in optim(s0, fmin, gmin, method = “BFGS”, …) : initial value in ‘vmmin’ is not finite
Table 11: Ordinal logistic regression models of Anemia grade by number of NaC cycles unadjusted and adjusted for chemotherapy receiced, stage and several other variables.
Factor: OR | extended | full | interaction | chemo | stage | simple |
0|1 | >1000 | 11.564 | 2.212 | 3.167 | 3.039 | 0.266 *** |
1|2 | >1000 | 381.95 ⁺ | 72.531 ** | 87.766 | 98.985 ** | 7.158 *** |
2|3 | >1000 * | >1000 * | >1000 *** | >1000 * | >1000 *** | 115.076 *** |
Neoadjuvant chemotherapy cycles | 1.249 [0.771, 2.073] | 1.238 [0.899, 1.73] | 1.265 [0.937, 1.735] | 1.415 * [1.07, 1.915] | 1.222 [0.891, 1.699] | 1.399 * |
Chemotherapy received (%) | 22.184 [0.003, >1000] | 4.901 [0.004, >1000] | 15.468 [0.016, >1000] | |||
Stage (numeric) | 3.015 [0.841, 12.135] | 2.356 ⁺ [0.921, 6.452] | 2.444 ⁺ [0.972, 6.614] | |||
(interaction) | 2.351 ⁺ [0.986, 5.95] | |||||
Age at diagnosis (years) | 1.084 * [1.016, 1.166] | |||||
Cis dose (mg/m²) | 0.979 [0.951, 1.006] | |||||
Concomitant chemotherapy | 5.002 [0.202, 141.082] | |||||
Radiotherapy duration (days) | 0.931 [0.766, 1.126] | |||||
Fractination used: 45/25 vs. 50.4/28 | 1.03 [0.472, 2.215] | |||||
Simultaneous integrated boost (SIB) | 1.889 [0.884, 4.278] | |||||
Radiotherapy to lombo-aortics | 0.764 [0.328, 1.71] | |||||
Sequential Boost instead of SIB | 1.904 [0.584, 6.345] | |||||
Brachytherapy fractions | 1.788 * [1.135, 2.972] | |||||
McFadden's pseudo-R² | 0.281 | 0.085 | 0.084 | 0.056 | 0.083 | 0.051 |
AIC | 110.2 | 114.0 | 112.1 | 115.2 | 112.2 | 113.8 |
3.9 NAC ~ Creatinin, Urinary, Digestive, RT to lombo-aortics
Figure 11: Creatinin toxicity, Urinary and Digestive Toxicity, RT to lombo-aortics by Neoadjuvant chemotherapy groups.
Error in optim(s0, fmin, gmin, method = “BFGS”, …) : initial value in ‘vmmin’ is not finite
Table 12: Ordinal logistic regression models of Digestive toxicity by number of NaC cycles unadjusted and adjusted for chemotherapy receiced, stage and several other variables.
Factor: OR | extended | full | interaction | chemo | stage | simple |
0|1 | 0.009 | 1.275 | 1.98 | 0.448 | 3.299 | 0.669 |
1|2 | 0.214 | 13.165 | 19.938 * | 4.395 | 33.925 * | 6.552 *** |
2|3 | 4.083 | 147.761 | 217.206 *** | 46.274 | 378.448 *** | 68.933 *** |
Neoadjuvant chemotherapy cycles | 0.718 [0.448, 1.118] | 1.015 [0.755, 1.371] | 1.06 [0.804, 1.408] | 1.123 [0.872, 1.458] | 1.023 [0.764, 1.376] | 1.124 |
Chemotherapy received (%) | 1.812 [<0.001, >1000] | 0.33 [<0.001, 280.767] | 0.645 [<0.001, 544.423] | |||
Stage (numeric) | 1.188 [0.394, 3.638] | 1.834 [0.74, 4.613] | 1.792 [0.73, 4.459] | |||
(interaction) | 1.542 [0.658, 3.633] | |||||
Age at diagnosis (years) | 0.954 [0.896, 1.012] | |||||
Cis dose (mg/m²) | 0.967 * [0.939, 0.992] | |||||
Concomitant chemotherapy | 0.625 [0.036, 10.952] | |||||
Radiotherapy duration (days) | 1.034 [0.903, 1.184] | |||||
Fractination used: 45/25 vs. 50.4/28 | 0.672 [0.341, 1.29] | |||||
Simultaneous integrated boost (SIB) | 1.202 [0.625, 2.346] | |||||
Radiotherapy to lombo-aortics | 3.938 ** [1.741, 9.892] | |||||
McFadden's pseudo-R² | 0.214 | 0.021 | 0.015 | 0.007 | 0.02 | 0.007 |
AIC | 122.8 | 132.7 | 131.4 | 132.4 | 130.8 | 130.4 |
4 RT given to LomboAortics
Table 13: Summary table for RT given to Lombo-aortics in NAC patients by several predictors.
Variabila | Detalii | yes | no | Total | Teste statistice |
Radiotherapy to lombo-aortics | 10 (45.5%) | 12 (54.5%) | 22 | ||
Group | NAC | 10 (100%) | 12 (100%) | 22 (100%) | OR=0.84 [0.02, 46.09] (p=1.000) |
Control | 0 | 0 | 0 | ||
Neoadjuvant chemotherapy cycles | M (min:max) | 4 (3:6) | 4 (2:6) | 4 (2:6) | MW: p=0.793 |
μ ±DS | 3.90 ±0.876 | 3.75 ±0.965 | 3.82 ±0.907 | ||
Age at diagnosis (years) | M (min:max) | 53 (29:67) | 57 (35:71) | 53.5 (29:71) | T-test: p=0.313 |
μ ±DS | 50.90 ±11.2 | 55.83 ±11.1 | 53.59 ±11.2 | ||
Stage | IB | 0 | 0 | 0 | V=0.57 (p=0.069) |
IIA | 0 | 0 | 0 | ||
IIB | 1 (10.0%) | 4 (33.3%) | 5 (22.7%) | ||
IIIA | 0 | 0 | 0 | ||
IIIB | 3 (30.0%) | 7 (58.3%) | 10 (45.5%) | ||
IVA | 4 (40.0%) | 1 (8.3%) | 5 (22.7%) | ||
IVB | 2 (20.0%) | 0 | 2 (9.1%) | ||
Stage (numeric) | M (min:max) | 4 (2.5:4.5) | 3.5 (2.5:4) | 3.5 (2.5:4.5) | MW: p=0.017 |
μ ±DS | 3.80 ±0.587 | 3.21 ±0.542 | 3.48 ±0.626 | ||
Dose used | Cis 30mg/m² | 1 (10.0%) | 2 (16.7%) | 3 (13.6%) | V=0.10 (p=0.650) |
Cis 40mg/m² | 9 (90.0%) | 10 (83.3%) | 19 (86.4%) | ||
Cis 100mg/m² | 0 | 0 | 0 | ||
Cis dose (mg/m²) | M (min:max) | 40 (30:40) | 40 (30:40) | 40 (30:40) | MW: p=0.698 |
μ ±DS | 39.00 ±3.16 | 38.33 ±3.89 | 38.64 ±3.51 | ||
Concomitant chemotherapy cycles | M (min:max) | 2 (1:5) | 2 (1:4) | 2 (1:5) | MW: p=0.700 |
μ ±DS | 2.20 ±1.23 | 2.25 ±0.866 | 2.23 ±1.02 | ||
Lost cycles | M (min:max) | 3 (0:4) | 3 (1:4) | 3 (0:4) | MW: p=0.700 |
μ ±DS | 2.80 ±1.23 | 2.75 ±0.866 | 2.77 ±1.02 | ||
Concomitant chemotherapy | M (min:max) | 0.4 (0.2:1) | 0.4 (0.2:0.8) | 0.4 (0.2:1) | MW: p=0.700 |
μ ±DS | 0.44 ±0.246 | 0.45 ±0.173 | 0.445 ±0.204 | ||
Chemotherapy received (%) | M (min:max) | 0.92 (0.75:1.01) | 0.93 (0.78:0.99) | 0.92 (0.75:1.01) | T-test: p=0.835 |
μ ±DS | 0.901 ±0.0813 | 0.908 ±0.0697 | 0.905 ±0.0734 | ||
Lowest Leucocyte count | M (min:max) | 2610 (850:6310) | 2375 (1640:3700) | 2460 (850:6310) | MW: p=0.381 |
μ ±DS | 2921.00 ±1541.3 | 2461.67 ±741.3 | 2670.45 ±1166.5 | ||
Leucopenia grade | 0 | 2 (20.0%) | 0 | 2 (9.1%) | V=0.55 (p=0.156) |
1 | 1 (10.0%) | 3 (25.0%) | 4 (18.2%) | ||
2 | 5 (50.0%) | 4 (33.3%) | 9 (40.9%) | ||
3 | 1 (10.0%) | 5 (41.7%) | 6 (27.3%) | ||
4 | 1 (10.0%) | 0 | 1 (4.5%) | ||
Lowest Neutrophile count | M (min:max) | 1842.5 (720:5190) | 1445 (910:2810) | 1520 (720:5190) | MW: p=0.381 |
μ ±DS | 2174.50 ±1375.9 | 1588.33 ±640.6 | 1854.77 ±1056.2 | ||
Neutropenia grade | 0 | 4 (40.0%) | 2 (16.7%) | 6 (27.3%) | V=0.30 (p=0.575) |
1 | 2 (20.0%) | 3 (25.0%) | 5 (22.7%) | ||
2 | 2 (20.0%) | 5 (41.7%) | 7 (31.8%) | ||
3 | 2 (20.0%) | 2 (16.7%) | 4 (18.2%) | ||
Lowest Lymphocyte count | M (min:max) | 355 (70:430) | 450 (380:950) | 405 (70:950) | MW: p<0.001 |
μ ±DS | 301.00 ±116.9 | 491.67 ±154.9 | 405.00 ±166.9 | ||
Lymphopenia grade | 1 | 0 | 1 (8.3%) | 1 (4.5%) | V=0.52 (p=0.118) |
2 | 0 | 3 (25.0%) | 3 (13.6%) | ||
3 | 8 (80.0%) | 8 (66.7%) | 16 (72.7%) | ||
4 | 2 (20.0%) | 0 | 2 (9.1%) | ||
Lowest Platelet count | M (min:max) | 151.5 (29:271) | 106.5 (68:198) | 126.5 (29:271) | Welch: p=0.423 |
μ ±DS | 142.60 ±75.1 | 121.17 ±35.3 | 130.91 ±56.5 | ||
Thrombocytopenia grade | 0 | 8 (80.0%) | 10 (83.3%) | 18 (81.8%) | V=0.43 (p=0.254) |
1 | 0 | 1 (8.3%) | 1 (4.5%) | ||
2 | 0 | 1 (8.3%) | 1 (4.5%) | ||
3 | 2 (20.0%) | 0 | 2 (9.1%) | ||
Lowest Hemoglobin | M (min:max) | 10.1 (7.6:11.2) | 10.35 (8.8:12.9) | 10.15 (7.6:12.9) | T-test: p=0.171 |
μ ±DS | 9.81 ±1.07 | 10.44 ±1.02 | 10.15 ±1.06 | ||
Anemia grade | 0 | 0 | 1 (8.3%) | 1 (4.5%) | V=0.34 (p=0.474) |
1 | 7 (70.0%) | 7 (58.3%) | 14 (63.6%) | ||
2 | 2 (20.0%) | 4 (33.3%) | 6 (27.3%) | ||
3 | 1 (10.0%) | 0 | 1 (4.5%) | ||
Creatinine level | normal | 8 (80.0%) | 12 (100%) | 20 (90.9%) | OR=0.14 [0.01, 3.20] (p=0.195) |
elevated | 2 (20.0%) | 0 | 2 (9.1%) | ||
Urinary toxicity | 2 (20.0%) | 6 (50.0%) | 8 (36.4%) | OR=0.25 [0.04, 1.70] (p=0.204) | |
Digestive toxicity | 0 | 2 (20.0%) | 4 (33.3%) | 6 (27.3%) | V=0.52 (p=0.118) |
1 | 4 (40.0%) | 8 (66.7%) | 12 (54.5%) | ||
2 | 3 (30.0%) | 0 | 3 (13.6%) | ||
3 | 1 (10.0%) | 0 | 1 (4.5%) | ||
Radiotherapy duration (days) | M (min:max) | 39 (35:72) | 37.5 (32:58) | 38 (32:72) | MW: p=0.219 |
μ ±DS | 44.10 ±11.5 | 40.08 ±8.69 | 41.91 ±10.0 | ||
Fractination used | 50.4/28 | 8 (80.0%) | 8 (66.7%) | 16 (72.7%) | OR=2.00 [0.28, 14.20] (p=0.646) |
45/25 | 2 (20.0%) | 4 (33.3%) | 6 (27.3%) | ||
Simultaneous integrated boost (SIB) | 7 (77.8%) | 6 (50.0%) | 13 (61.9%) | OR=3.50 [0.50, 24.27] (p=0.367) | |
Sequential Boost instead of SIB | 4 (40.0%) | 2 (16.7%) | 6 (27.3%) | OR=3.33 [0.46, 24.05] (p=0.348) | |
Brachytherapy fractions | M (min:max) | 3 (0:4) | 3 (0:4) | 3 (0:4) | MW: p=0.709 |
μ ±DS | 2.78 ±1.48 | 2.42 ±1.73 | 2.57 ±1.6 | ||
μ ±DS = Media (deviația standard); M (min:max) = Mediana (min:max); MW = Test Mann-Whitney; OR/RR = odds-ratio / risc relativ [cu IC 95%] și p calculat prin testul Fisher); V = Cramer V (p calculat prin testul Chi²); | |||||
5 extra
names(canva_palettes) %>% sort(decreasing = T) [1] "Wintery reds"
[2] "Watery blue-greens"
[3] "Warm tones"
[4] "Warm naturals"
[5] "Warm and wonderful"
[6] "Warm and rustic"
[7] "Warm and cool"
[8] "Warm and bold"
[9] "Violet sunset"
[10] "Vintage charm 2"
[11] "Vintage charm"
[12] "Vineyard neutrals"
[13] "Urban oasis"
[14] "Urban living"
[15] "Unique and striking"
[16] "Unexpected color combinations"
[17] "Understated and versatile"
[18] "Tropical tones"
[19] "Trendy and metropolitan"
[20] "Tints and tones"
[21] "Timeless and nautical"
[22] "Technology meets nature"
[23] "Surf and turf"
[24] "Sunset to dusk"
[25] "Sunny citrus"
[26] "Sunny and calm"
[27] "Sunkissed village"
[28] "Sun and sky"
[29] "Summer sunflower"
[30] "Summer inspired"
[31] "Summer fiesta"
[32] "Summer barbeque"
[33] "Subtle and versatile"
[34] "Subdued and proffesional"
[35] "Stylish and retro"
[36] "Striking and energetic"
[37] "Strawberries and cream"
[38] "Stormy hues"
[39] "Splash of color"
[40] "Spicy neutrals"
[41] "Smoky purples"
[42] "Sleek and modern"
[43] "Simple but bold"
[44] "Simple and fresh"
[45] "Sharp and modern"
[46] "Shadowy and dramatic"
[47] "Shades of citrus"
[48] "Shabby chic neutrals"
[49] "Serene and spa like"
[50] "Retro inspired"
[51] "Retro and relaxing"
[52] "Refreshing and pretty"
[53] "Professional and traditional"
[54] "Professional and modern"
[55] "Primary colors with a vibrant twist"
[56] "Pretty pastels"
[57] "Pop art"
[58] "Pool party"
[59] "Polished and inviting"
[60] "Playful greens and blues"
[61] "Pastels"
[62] "Outdoorsy and Natural"
[63] "Orange accent"
[64] "Nightlife"
[65] "Neutral and versatile"
[66] "Neon tones and sharp contrast"
[67] "Neon night"
[68] "Neon and bold"
[69] "Naturally elegant"
[70] "Muted tones"
[71] "Muted and minimal"
[72] "Muted and antique"
[73] "Modern and urban"
[74] "Modern and muted"
[75] "Modern and minimal"
[76] "Modern and crisp"
[77] "Modern and clean"
[78] "Misty greens"
[79] "Mediterranean afternoon"
[80] "Maritime brights"
[81] "Luxurious and modern"
[82] "Light and natural"
[83] "Lemonade stand"
[84] "Jewel tones"
[85] "Industrial and in control"
[86] "Icy blues and grays"
[87] "High saturation and high energy"
[88] "Hazy grays"
[89] "Green fields"
[90] "Grecian holiday"
[91] "Golden afternoon"
[92] "Garden fresh"
[93] "Fun and tropical"
[94] "Fun and professional"
[95] "Fun and cheerful"
[96] "Fresh greens"
[97] "Fresh and lively"
[98] "Fresh and energetic"
[99] "Fresh and bright"
[100] "Exotic and high impact"
[101] "Elegant and sophisticated"
[102] "Earthy and fresh"
[103] "Distintive and unexpected"
[104] "Day and night"
[105] "Dark and handsome"
[106] "Dark and earthy"
[107] "Crisp complementary colors"
[108] "Crisp and dramatic"
[109] "Cozy and warm"
[110] "Cosmopolitan"
[111] "Corporate and sleek"
[112] "Cool vs warm"
[113] "Cool jewel tones"
[114] "Cool blues"
[115] "Cool and calm"
[116] "Colorful without clashing"
[117] "Coastal"
[118] "Clean gradient and fresh blues"
[119] "Clean and highlighted"
[120] "Clean and crisp"
[121] "Clean and collegiate"
[122] "Classy and timeless"
[123] "Classic metallics"
[124] "City sights"
[125] "Chocolaty browns"
[126] "Cheerful brights"
[127] "Cheerful blues and pink"
[128] "Cheerful and sleek"
[129] "Cheerful and friendly"
[130] "Candy coated brights"
[131] "Bright and tropical"
[132] "Bright and painterly"
[133] "Bold feature colors"
[134] "Bold blacks and vibrand highlights"
[135] "Bold berries"
[136] "Bold and punchy"
[137] "Bold and cultured"
[138] "Bold and basic"
[139] "Birds and berries"
[140] "Beyond black and white"
[141] "Berry blues"
[142] "Back to school"
[143] "Autumn oranges and complemtentary neutrals"
[144] "Autumn in vermont"
[145] "Artic sunrise"
[146] "Art history inspired"
[147] "Aqua blues"
[148] "Antique tones"
[149] "Antique and clean"
[150] "1950s kitchen" canva_df <- purrr::map2_df(canva_palettes, names(canva_palettes) ,
~ tibble(colors = .x, .id = seq_along(colors),
palette = .y))
ggplot(canva_df, aes(y = palette, x = .id, fill = colors)) +
geom_raster() +
scale_fill_identity(guide = FALSE) +
theme_minimal() +
theme(panel.grid = element_blank(),
axis.text.x = element_blank()) +
labs(x = "", y = "")