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一种用于预测鼻咽癌患者放疗后营养风险的动态在线列线图。

A dynamic online nomogram for predicting nutritional risk in nasopharyngeal carcinoma patients after radiotherapy.

作者信息

Zhu Benxiang, Liu Lian, Zhang Lu, Cao Min, Gao Chang, Chen Peijuan

机构信息

School of Nursing, Southern Medical University, No. 1023 Sha Tai South Road, Baiyun District, Guangzhou, 510515, China.

Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Guangzhou, 510515, China.

出版信息

Support Care Cancer. 2025 May 28;33(6):506. doi: 10.1007/s00520-025-09547-x.

Abstract

PURPOSE

Malnutrition is a prevalent and detrimental complication in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy. Early identification and intervention are crucial for optimizing outcomes.

METHODS

We retrospectively analyzed data from 383 patients with NPC who underwent radiotherapy. We employed logistic regression analysis to identify risk factors for malnutrition and developed a nomogram for its prediction. The nomogram was internally and externally validated using bootstrap methods and calibration curves.

RESULTS

Body mass index (BMI), chemotherapy cycles, central venous catheter (CVC), and alanine aminotransferase (ALT) were identified as independent risk factors for malnutrition. The nomogram demonstrated good discriminatory ability (AUC: 0.786 in the training set, 0.687 in the validation set) and clinical utility, with high net benefit in decision curve analysis.

CONCLUSIONS

This nomogram offers a practical tool for predicting nutritional risk in patients with NPC undergoing radiotherapy. Its application can facilitate early identification of at-risk patients and guide targeted interventions to improve clinical outcomes.

摘要

目的

营养不良是接受放疗的鼻咽癌(NPC)患者中普遍存在且有害的并发症。早期识别和干预对于优化治疗结果至关重要。

方法

我们回顾性分析了383例接受放疗的NPC患者的数据。我们采用逻辑回归分析来确定营养不良的危险因素,并制定了用于预测的列线图。使用自助法和校准曲线对列线图进行内部和外部验证。

结果

体重指数(BMI)、化疗周期、中心静脉导管(CVC)和丙氨酸转氨酶(ALT)被确定为营养不良的独立危险因素。列线图显示出良好的辨别能力(训练集的AUC为0.786,验证集的AUC为0.687)和临床实用性,在决策曲线分析中具有较高的净效益。

结论

该列线图为预测接受放疗的NPC患者的营养风险提供了一种实用工具。其应用可促进对高危患者的早期识别,并指导针对性干预以改善临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9952/12119778/47e4503e2fa4/520_2025_9547_Fig1_HTML.jpg

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