Nutrition and Dietetics Section, Brazilian National Cancer Institute Jose Alencar Gomes da Silva (INCA), Rio de Janeiro, RJ, Brazil.
Clin Nutr ESPEN. 2023 Oct;57:89-95. doi: 10.1016/j.clnesp.2023.06.020. Epub 2023 Jun 24.
BACKGROUND & AIMS: Central nervous system tumors (CNS) are the second most common malignancies in childhood. Inflammation and changes in nutritional status play an important role and can be used as prognostic markers. Thus, this study aimed to evaluate the predictive ability of nutritional status and inflammatory markers on overall survival (OS) of pediatric patients with CNS.
In this retrospective cohort study, 103 patients were followed for 5 years. Clinical, anthropometric, and hematological data were collected. Body mass index for age (BMI/A), neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation response index (SIRI) were calculated. OS curves were calculated using the Kaplan Meier method and evaluated using the Log-Rank test. The Cox proportional hazards model was performed to identify independent variables associated with prognostic factors, generating hazard ratios (HR) and 95% confidence intervals (CI).
Nutritional status did not significantly affect OS. However, patients with NLR ≥2.18 and SIRI ≥1249.18 had significantly lower OS in 5 years. Only treatment and high NLR were identified as independent prognostic factors for worse OS. Treatment with exclusive radiotherapy or chemotherapy (HR: 16.22, 95% CI: 2.19-120.07) and NLR (HR: 1.94, 95% CI: 1.02-3.69) were identified as independent prognostic factors for worse OS at 5 years.
High pretreatment NLR was shown to be an independent prognostic factor for OS in pediatric patients with CNS.
中枢神经系统肿瘤（CNS）是儿童第二大常见恶性肿瘤。炎症和营养状况的变化起着重要作用，可以作为预后标志物。因此，本研究旨在评估营养状况和炎症标志物对儿童 CNS 患者总生存期（OS）的预测能力。
在这项回顾性队列研究中，对 103 例患者进行了 5 年随访。收集了临床、人体测量学和血液学数据。计算了年龄别体重指数（BMI/A）、中性粒细胞与淋巴细胞比值（NLR）和全身炎症反应指数（SIRI）。使用 Kaplan-Meier 方法计算 OS 曲线，并使用对数秩检验进行评估。使用 Cox 比例风险模型确定与预后因素相关的独立变量，生成风险比（HR）和 95%置信区间（CI）。
营养状况对 OS 无显著影响。然而，NLR≥2.18 和 SIRI≥1249.18 的患者在 5 年内 OS 显著降低。只有治疗和高 NLR 被确定为 OS 较差的独立预后因素。单纯放疗或化疗治疗（HR：16.22，95%CI：2.19-120.07）和 NLR（HR：1.94，95%CI：1.02-3.69）是 5 年 OS 较差的独立预后因素。
高预处理 NLR 被证明是儿童 CNS 患者 OS 的独立预后因素。
