{
  "abstract": "Objectives: Radiation-induced hypothyroidism (RIHT) is a common late toxicity after head and neck radiotherapy. We aimed to develop and externally validate a multimodal Cox model for patient-specific cumulative RIHT risk assessment. Materials & methods: This retrospective multicentre study included 1407 patients across four cohorts. The model was developed in the training cohort and externally validated in three independent cohorts. Candidate predictors included CT radiomics, dosiomics, dose-volume histogram parameters, and clinical variables. A multimodal Cox model was developed and used to estimate cumulative risks across time horizons. Temporal risk groups were derived from predicted 3- and 7-year risks. Results: A total of 1407 patients (mean age, 55.4 ± 13.8 years; 1027 men) were evaluated and RIHT occurred in 694 (49.3%). The final model integrated three CT radiomics features, four dosiomics features, mean thyroid dose, age and N stage. It achieved C-index/overall AUC values of 0.714/0.765 in the development cohort and 0.725/0.800, 0.680/0.754, and 0.627/0.690 in the three external validation cohorts. Four temporal risk groups had RIHT event rates of 21.7%, 46.1%, 58.3%, and 71.8%, with significant differences in RIHT-free survival (log-rank p < 0.001). The model was packaged as an open-source software tool for individualised risk assessment. Conclusion: The externally validated multimodal Cox model provided time-resolved, patient-specific RIHT risk estimates and temporal risk stratification using routinely available radiotherapy-planning data.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China",
    "Xijing Hospital, The Fourth Military Medical University, Xi'an, China",
    "Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China; Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China",
    "Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China",
    "Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong SAR, China",
    "Department of Clinical Oncology, The University of Hong Kong, Hong Kong SAR, China",
    "Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China; Corresponding authors.",
    "Xijing Hospital, The Fourth Military Medical University, Xi'an, China; Corresponding authors.",
    "Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China; Corresponding author at: Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong SAR, China."
  ],
  "article_type": "research article",
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  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jiaming Wu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jie Gong"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiang Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xinzhi Teng"
    },
    {
      "affs": [
        0
      ],
      "name": "Xinyu Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Jeffrey C.F. Lui"
    },
    {
      "affs": [
        3
      ],
      "name": "Ka Man Cheung"
    },
    {
      "affs": [
        3
      ],
      "name": "Kwok Hung Au"
    },
    {
      "affs": [
        4
      ],
      "name": "Kenneth C.W. Wong"
    },
    {
      "affs": [
        4
      ],
      "name": "Dave K.W. Yeung"
    },
    {
      "affs": [
        5
      ],
      "name": "Victor H.F. Lee"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Cai"
    },
    {
      "affs": [
        6
      ],
      "name": "Tian Li"
    },
    {
      "affs": [
        7
      ],
      "name": "Jian Zang"
    },
    {
      "affs": [
        8
      ],
      "name": "James C.H. Chow"
    }
  ],
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  "doi": "10.1016/j.ctro.2026.101325",
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  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
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  "pdf_url": "https://www.ctro.science/article/S2405-6308(26)00220-X/pdf",
  "pmcid": "PMC13718680",
  "pmid": "42959946",
  "published": "2026-10-16",
  "publisher": "Elsevier",
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  ],
  "title": "Development and validation of a cumulative risk model and assessment tool for radiation-induced hypothyroidism in head and neck cancer: a multicentre study",
  "title_text": "Development and validation of a cumulative risk model and assessment tool for radiation-induced hypothyroidism in head and neck cancer: a multicentre study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:22:39Z",
  "url": "https://research.draconitic.com/paper/4bmvqw9bh4dmd",
  "venue": "Clinical and Translational Radiation Oncology",
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