{
  "abstract": "Background: Radiotherapy treatment plan comparisons often utilize structure doses, tumor control probabilities (TCPs), and normal tissue complication probabilities (NTCPs), but such metrics do not reflect the duration for which a patient suffers from a developed toxicity. Markov models allowing for the simulation of the patient's entire lifetime post-treatment and the determination of quality-adjusted life expectancy (QALE) have been developed but generally disregard important considerations such as additional treatments received and second primary malignancies (SPMs). Clinical validation also largely remains outstanding. Purpose: This study aims to expand and clinically validate a Markov model focusing on head-and-neck cancer patients. Methods: A Markov model considering tumor control, healthy tissue toxicities, distant metastases, radiation-associated secondary cancer, and death from various causes was expanded to further include additional treatments received, SPMs, and the patient's smoking history. For each of 148 head-and-neck cancer patients, 437,000 simulations of the patient's entire lifetime post-treatment were performed and compared to the patient's clinically-documented outcomes (wherever available). Results: 94.4% of simulations exhibited locoregional control, compared to 89.9% of patients in clinical reality. Simulated death with locoregional failure was 4.9%, compared to 5.4% in real life. Patients developed and died with distant metastases in 8.0% of simulations, while 10.8% of patients developed distant metastases in real life and 5.7% of patients passed away with distant disease. The simulated second primary cancer rate was 13.5%. Patients exhibited at least one healthy tissue toxicity in 43.8% of simulations, and simulated life expectancy and QALE were 76.5 ± 11.6 years and 74.3 ± 11.0 quality-adjusted life years (QALYs), respectively. Conclusions: Agreement between simulation results and available clinicallydocumented outcomes was generally excellent, enabling the evaluation of prospective clinical outcomes and comparisons between different patient populations along with variable treatment combinations.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "Sebastian Tattenberg"
    },
    {
      "name": "Benoit Allignet"
    },
    {
      "name": "Xuanfeng Ding"
    },
    {
      "name": "Cornelia Hoehr"
    },
    {
      "name": "Peter Chen"
    },
    {
      "name": "Olivier Beuf"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6wzcv1754txpg.bib",
  "cited_by": 0,
  "doi": "10.1002/mp.70696",
  "fulltext_url": null,
  "id": "6wzcv1754txpg",
  "issns": [
    "0094-2405",
    "2473-4209"
  ],
  "landing_url": "https://hal.science/hal-05787066v1",
  "language": "en",
  "licence": "CC-BY-NC-SA-4.0",
  "licence_label": "CC BY-NC-SA 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-sa/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "0.spi"
    ],
    [
      "openalex",
      "2002|Health Systems, Economic Evaluations, Quality of Life"
    ]
  ],
  "openalex": "W7220741735",
  "pdf_url": "https://hal.science/hal-05787066/document",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-15",
  "publisher": "American Association of Physicists in Medicine",
  "ris": "https://research.draconitic.com/paper/6wzcv1754txpg.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:51Z",
      "native_id": "hal-05787066",
      "source": "hal",
      "url": "https://hal.science/hal-05787066v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    }
  ],
  "title": "Expansion and clinical validation of Markov model‐based quality‐adjusted life expectancy (QALE) simulations for head‐and‐neck cancer radiotherapy patients",
  "title_text": "Expansion and clinical validation of Markov model‐based quality‐adjusted life expectancy (QALE) simulations for head‐and‐neck cancer radiotherapy patients",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:51Z",
  "url": "https://research.draconitic.com/paper/6wzcv1754txpg",
  "venue": "Medical Physics : The international journal of medical physics research and practice",
  "versions": []
}