GNRI和CONUT评分对老年局部晚期NSCLC病人放疗后发生≥2级放射性肺炎的预测价值

doi:10.3969/j.issn.1003-9198.2024.08.017

Abstract

Abstract: Objective To analyze the predictive value of geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) score for ≥grade 2 radiation pneumonia (RP) after radiotherapy in the elderly patients with locally advanced non-small cell lung cancer (NSCLC). Methods A total of 81 elderly patients with stage Ⅲ NSCLC aged ≥65 years who received radiotherapy in our hospital from January 2019 to January 2022 were enrolled in this study, and they were followed up for 3 months after radiotherapy. According to the occurrence of RP, the patients were divided into ≥grade 2 RP group (group A,25 cases) and ＜grade 2 group (group B,56 cases). The clinical data and radiotherapy dosimetry parameters of the patients were collected. GNRI and CONUT scores at the end of radiotherapy were evaluated and compared between the two groups. Multivariate Logistic regression analysis was used to explore the influencing factors of ≥grade 2 RP after radiotherapy, and receiver operating characteristic(ROC)curve was used to analyze the predictive value of GNRI and CONUT scores for ≥grade 2 RP after radiotherapy in the elderly patients with locally advanced NSCLC. Results The dosimetry comparison between the two groups showed that V20 (percentage of lung volume receiving radiation dose ＞20 Gy in both lungs) in group A was higher than that in group B (P < 0.05). At the end of radiotherapy, GNRI was lower while the CONUT score was higher in group A than that in group B (P < 0.05) . Multivariate Logistic regression showed that low GNRI and high CONUT score at the end of radiotherapy were independent risk factors for ≥grade 2 RP after radiotherapy in the elderly patients with locally advanced NSCLC. ROC curve analysis showed that the cut-off value of GNRI and CONUT score in predicting ≥grade 2 RP after radiotherapy was 94.22 and 4.5, with an area under the curve(AUC) of 0.785 and 0.894 respectively. The AUC of the combination of GNRI and CONUT score in predicting ≥grade 2 RP after radiotherapy was 0.925, and the sensitivity was 0.840, and the specificity was 0.929. Conclusions Low GNRI and high CONUT score at the end of radiotherapy are independent risk factors for ≥grade 2 RP after radiotherapy in the elderly patients with locally advanced NSCLC, and combination of GNRI and CONUT score have high predictive value.

Key words: locally advanced non-small cell lung cancer, aged, radiation pneumonia, geriatric nutrition risk index, controlling nutritional status score

CLC Number:

R734.2

HUANG Rui. Prediction value of GNRI and CONUT score for≥grade 2 radiation pneumonia after radiotherapy in elderly patients with locally advanced non-small cell lung cancer[J]. Practical Geriatrics, 2024, 38(8): 831-836.

References

[1] DUMA N, SANTANA-DAVILA R, MOLINA J R. Non-small cell lung cancer: epidemiology, screening, diagnosis, and treatment[J]. Mayo Clin Proc, 2019, 94(8):1623-1640.
[2] HUNG M S, WU Y F, CHEN Y C. Efficacy of chemoradiotherapy versus radiation alone in patients with inoperable locally advanced non-small-cell lung cancer: a meta-analysis and systematic review[J]. Medicine, 2019, 98(27):e16167.
[3] KUANG Y, PIERCE C M, CHANG H C, et al. Chemoradiation-induced pneumonitis in patients with unresectable stage III non-small cell lung cancer: a systematic literature review and meta-analysis[J]. Lung Cancer, 2022,174:174-185.
[4] SHEPHERD A F, LOCOLANO M,LEEMAN J,et al. Clinical and dosimetric predictors of radiation pneumonitis in patients with non-small cell lung cancer undergoing postoperative radiation therapy[J]. Pract Radiat Oncol, 2020, 11(1):e52-e62.
[5] ABD AZIZ N A S, TENG M F T, ZAMAN M K. Geriatric nutrition risk index is comparable to the mini nutritional assessment for assessing nutritional status in elderly hospitalized patients[J]. Clin Nutr ESPEN, 2019, 29: 77-85.
[6] SUGIYAMA Y, NAIKI T, TASAKI Y, et al. GNRI sustainability during one cycle of first-line chemotherapy as a prognostic indicator in patients with metastatic urothelial carcinoma[J]. Oncology,2023,101(4):224-233.
[7] HAYAMA T, HASHIGUCHI Y, OZAWA T, et al. The preoperative geriatric nutritional risk index (GNRI) is an independent prognostic factor in elderly patients underwent curative resection for colorectal cancer[J]. Sci Rep,2022,12(1):3682.
[8] CHEN J, SONG P, PENG Z, et al. The controlling nutritional status (CONUT) score and prognosis in malignant tumors: a systematic review and meta-analysis[J]. Nutr Cancer,2022,74(9):3146-3163.
[9] COX J D, STETZ J, PAJAK T F. Toxicity criteria of the radiation therapy oncology group (RTOG) and the European organization for research and treatment of cancer (EORTC)[J]. Int J Radiat Oncol Biol Phys,1995,31(5):1341-1346.
[10] BOUILLANNE O,MORINEAU G,DUPONT C, et al. Geriatric nutritional risk index:a new index for evaluating at-risk elderly medical patients[J]. Am J Clin Nutr,2005,82(4):777-783.
[11] IGNACIO DE ULBARRI J, GONZAIEZ-MADRONO A, DE VILLAR N G, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population[J]. Nutr Hosp,2005,20(1):38-45.
[12] SHI L L, YANG J H, YAO H F. Multiple regression analysis of risk factors related to radiation pneumonitis[J]. World J Clin Cases,2023,11(5):1040-1048.
[13] ZHANG T, BI N, ZHOU Z, et al. The impact of age on the survival outcomes and risk of radiation pneumonitis in patients with unresectable locally advanced non-small cell lung cancer receiving chemoradiotherapy[J]. J Thorac Dis,2020,12(8):4347-4356.
[14] HURMUZ P, CENGIZ M, ESEN C S B, et al. Factors affecting post-treatment radiation-induced lung disease in patients receiving stereotactic body radiotherapy to lung[J]. Radiat Environ Biophys,2021,60(1):87-92.
[15] ZHOU Y, YAN T, ZHOU X, et al. Acute severe radiation pneumonitis among non-small cell lung cancer (NSCLC) patients with moderate pulmonary dysfunction receiving definitive concurrent chemoradiotherapy: impact of pre-treatment pulmonary function parameters[J]. Strahlenther Onkol, 2020,196(6):505-514.
[16] KONG M, LIM Y J, KIM Y, et al. Diabetes mellitus is a predictive factor for radiation pneumonitis after thoracic radiotherapy in patients with lung cancer[J]. Cancer Manag Res, 2019, 11: 7103-7110.
[17] TEPETAM H, KARABULUT GUL S, ALOMARI O, et al. Does shortening the duration of radiotherapy treatment in breast cancer increase the risk of radiation pneumonia: a retrospective study[J]. Medicine: Baltimore,2023,102(12):e33303.
[18] LEE Y H, CHOI H S, JEONG H, et al. Neutrophil-lymphocyte ratio and a dosimetric factor for predicting symptomatic radiation pneumonitis in non-small-cell lung cancer patients treated with concurrent chemoradiotherapy[J]. Clin Respir J, 2018,12(3):1264-1273.
[19] GAO Y, WU X, LI Y, et al. The predictive value of MLR for radiation pneumonia during radiotherapy of thoracic tumor patients[J]. Cancer Manag Res, 2020,12:8695-8701.
[20] RYU H, SONG C, KIM J S, et al. Role of prognostic nutritional index in postoperative radiotherapy for non-small cell lung cancer[J]. Thorac Cancer, 2023,14(28):2859-2868.
[21] LI L, WANG Y, YANG P, et al. Correlation of the controlling nutritional status score and the prognostic nutritional index with the prognosis of patients treated with radiotherapy for small-cell lung cancer[J]. Ann Palliat Med, 2021,10(11):11635-11642.
[22] MA L, YE W, LI Q, et al. Subjective global assessment (SGA) score could be a predictive factor for radiation pneumonitis in lung cancer patients with normal pulmonary function treated by intensity-modulated radiation therapy and concurrent chemotherapy[J]. Clin Lung Cancer, 2018,19(2):e211-e217.

Prediction value of GNRI and CONUT score for≥grade 2 radiation pneumonia after radiotherapy in elderly patients with locally advanced non-small cell lung cancer

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