Kinoshita Ryosuke, Nakao Makoto, Kiyotoshi Hiroko, Sugihara Masahiro, Kuriyama Mamiko, Takeda Norihisa, Muramatsu Hideki
Department of Respiratory Medicine, Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Yatomi, Japan.
Cancer Diagn Progn. 2024 Jul 3;4(4):482-488. doi: 10.21873/cdp.10352. eCollection 2024 Jul-Aug.
BACKGROUND/AIM: The Geriatric Nutritional Risk Index (GNRI) indicates nutritional status based on serum albumin concentration and ideal body weight. Pretreatment GNRI has been suggested as a prognostic factor for various malignancies. However, little is known about the clinical value of GNRI for small-cell lung cancer (SCLC), especially in elderly patients.
We retrospectively analyzed 53 elderly (≥71) patients with extensive-disease (ED) SCLC treated with first-line platinum-doublet chemotherapy in relation to the pretreatment GNRI level in a real-world setting.
Thirty-six patients with a low GNRI (<92) had statistically poorer progression-free survival (PFS) and overall survival (OS) than 17 patients with a high GNRI (≥92) (median PFS=80 days vs. 133 days, respectively; p=0.002; median OS=123 days vs. 274 days, respectively; p=0.004). In a multivariate analysis, a low GNRI was also an independent poor prognostic factor for PFS [hazard ratio (HR)=0.396; 95% confidence interval (CI)=0.199-0.789; p=0.008] and OS (HR=0.295; 95%CI=0.143-0.608; p<0.001).
The GNRI might be a predictive and prognostic marker in elderly patients with ED-SCLC treated with platinum-doublet chemotherapy.
背景/目的:老年营养风险指数(GNRI)基于血清白蛋白浓度和理想体重来指示营养状况。治疗前的GNRI已被认为是各种恶性肿瘤的预后因素。然而,关于GNRI对小细胞肺癌(SCLC)的临床价值知之甚少,尤其是在老年患者中。
我们回顾性分析了53例年龄≥71岁、患有广泛期(ED)SCLC且接受一线铂类双联化疗的老年患者,分析其治疗前GNRI水平与实际临床情况的关系。
36例GNRI低(<92)的患者与17例GNRI高(≥92)的患者相比,无进展生存期(PFS)和总生存期(OS)在统计学上显著更差(中位PFS分别为80天和133天;p=0.002;中位OS分别为123天和274天;p=0.004)。在多变量分析中,低GNRI也是PFS的独立不良预后因素[风险比(HR)=0.396;95%置信区间(CI)=0.199-0.789;p=0.008]和OS的独立不良预后因素(HR=0.295;95%CI=0.143-0.608;p<0.001)。
GNRI可能是接受铂类双联化疗的老年ED-SCLC患者的预测和预后标志物。