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 - Summary - 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
To evaluate baseline pre-chemotherapy SII and PNI to construct a validated nomogram specifically for predicting severe chemotherapy-induced toxicity in stage II/III colorectal cancer patients.
Key Findings:
Severe CIT occurred in 25.5% of patients (p < 0.001).
High SII and low PNI were independent risk factors for severe toxicity (p < 0.001).
The nomogram showed excellent discrimination (apparent AUC: 0.868) and strong calibration (Brier score: 0.1114).
High-risk patients had shorter therapy duration (4.1 vs. 4.8 months, p < 0.001) and lower oxaliplatin dose intensity (median 76.7% vs. 100.0%, p < 0.001).
Interpretation:
Elevated SII and decreased PNI are robust predictors of severe toxicity in CRC patients undergoing chemotherapy, enabling risk-adapted management strategies that can improve patient outcomes.
Limitations:
Retrospective design may introduce selection bias and limit generalizability.
Findings need external validation in diverse populations.
Conclusion:
The proposed nomogram is a reliable, cost-effective tool for risk stratification in CRC patients, facilitating personalized management strategies.
