Development and validation of a pre-chemotherapy nomogram integrating systemic immune-inflammation index and prognostic nutritional index to predict severe adjuvant toxicity in colorectal cancer - Report - MDSpire
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Development and validation of a pre-chemotherapy nomogram integrating systemic immune-inflammation index and prognostic nutritional index to predict severe adjuvant toxicity in colorectal cancer
Clinical Report: Pre-Chemotherapy Nomogram for Toxicity in Colorectal Cancer
Overview
This study developed a nomogram utilizing the Systemic Immune-Inflammation Index (SII) and Prognostic Nutritional Index (PNI) to predict severe chemotherapy-induced toxicity (CIT) in stage II/III colorectal cancer patients. The nomogram demonstrated excellent discrimination and calibration, offering a reliable tool for risk stratification.
Background
Colorectal cancer (CRC) is a leading cause of cancer-related mortality, with adjuvant chemotherapy often complicated by severe toxicities that can lead to dose reductions and compromised outcomes. Identifying objective biomarkers for predicting chemotherapy tolerance is crucial for personalized treatment strategies, as traditional methods may not accurately reflect individual patient risk.
Data Highlights
Parameter
Value
Severe CIT Incidence
25.5%
Adjusted OR for High SII
8.56
Adjusted OR for Low PNI
4.69
Apparent AUC
0.868
Optimism-Corrected AUC
0.867
Brier Score
0.1114
Key Findings
Severe chemotherapy-induced toxicity occurred in 25.5% of patients.
High SII was an independent risk factor for severe CIT (adjusted OR = 8.56).
Low PNI was also an independent risk factor for severe CIT (adjusted OR = 4.69).
The nomogram showed excellent discrimination with an apparent AUC of 0.868.
Patients in the high-risk group had a significantly shorter median therapy duration (4.1 vs. 4.8 months).
The nomogram provided greater net clinical benefit compared to single markers or traditional assessments.
Clinical Implications
The nomogram developed in this study can aid clinicians in identifying high-risk patients for severe chemotherapy-induced toxicity, allowing for tailored management strategies. Implementing nutritional prehabilitation and dose adjustments based on SII and PNI can potentially improve treatment outcomes and patient quality of life.
Conclusion
The pre-chemotherapy nomogram utilizing SII and PNI is a valuable tool for predicting severe toxicity in CRC patients, facilitating personalized treatment approaches that may enhance therapeutic efficacy and minimize adverse effects.
