Clinical Scorecard: Creation and assessment of a pre-chemotherapy nomogram utilizing the systemic immune-inflammation index and prognostic nutritional index to forecast significant adjuvant toxicity in colorectal cancer

At a Glance

Key Highlights

• 25.5% of patients experienced severe chemotherapy-induced toxicity (CIT).
• High SII and low PNI are independent risk factors for severe CIT.
• The nomogram showed excellent discrimination and calibration for predicting toxicity.
• Patients in the high-risk group had significantly shorter therapy duration and lower dose intensity.
• The nomogram provides a cost-effective tool for risk stratification.

Guideline-Based Recommendations

Diagnosis

• Utilize SII and PNI as baseline markers for assessing risk of severe CIT.

Management

• Implement risk-adapted strategies including nutritional prehabilitation and dose adjustments for high-risk patients.

Monitoring & Follow-up

• Monitor patients with elevated SII and decreased PNI closely for adverse events.

Risks

• Severe CIT can lead to dose reductions, treatment delays, and compromised long-term outcomes.

Patient & Prescribing Data

306 patients with stage II/III CRC receiving oxaliplatin-based chemotherapy.

High-risk patients experienced a median therapy duration of 4.1 months and lower oxaliplatin relative dose intensity.

Clinical Best Practices

• Incorporate SII and PNI into routine pre-chemotherapy assessments.
• Use the nomogram to guide personalized treatment plans.
• Consider proactive growth factor support for patients identified as high-risk.

Related Resources & Content

• Study on SII and PNI in CRC