The predictive value of prognostic nutritional index and lymphocyte-monocyte ratio in the development of severe radiotherapy-induced oral mucositis during the treatment of patients with head and neck cancer
10.16066/j.1672-7002.2024.09.004
- VernacularTitle:预后营养指数及淋巴细胞与单核细胞比值在头颈肿瘤患者治疗期间发生重度放射性口腔黏膜炎的预测价值
- Author:
Fei GAO
1
,
2
;
Meizi LIU
;
Zitong WU
;
Ran AN
;
Wenfeng CHEN
Author Information
1. 中南大学湘雅护理学院,湖南 长沙 410013
2. 中南大学湘雅医院头颈肿瘤科,湖南 长沙 410008
- Keywords:
Head and Neck Neoplasms;
severe radiotherapy-induced oral mucositis;
prognostic nutritional index;
lymphocyte-to-monocyte ratio;
prediction model
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2024;31(9):559-564
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To investigate the predictive value of prognostic nutritional index(PNI) and lymphocyte-monocyte ratio(LMR) in severe radiotherapy-induced oral mucositis(RIOM) during treatment of patients with head and neck cancer,and to construct a risk prediction model and test the prediction effect. METHODS A total of 502 patients with head and neck cancer who underwent radiotherapy were recruited from September 2021 to October 2023 in Xiangya Hospital Central South University. The participants were randomly divided into training group and validation group at a ratio of 7:3. According to whether severe RIOM occurred,they were divided into severe RIOM group and non-severe RIOM group. Univariate analysis and logistic regression analysis were used to screen the risk factors of severe RIOM. The receiver operating characteristic(ROC) curve was used to evaluate its prediction effect and R4.3.2 software was used to draw nomograms and decision curve. RESULTS The risk prediction model for patients with head and neck cancer during treatment had five factors,including the number of comorbidities(OR=2.221,95％CI=1.185-4.165),surgical history(OR=2.938,95％CI=1.393-6.198),the degree of tumor differentiation(OR=1.511,95％CI=1.090-2.094),PNI(OR=0.892,95％CI=0.852-0.934),LMR(OR=0.512,95％CI=0.254-1.030). Model formula:Y=2.102+0.413×degree of differentiation+0.798×number of comorbidities+1.078×surgical history-0.114×PNI-0.669×LMR. The validation results of the prediction model showed that the area under the ROC curve of the training group was 0.847(P<0.001),the area under the curve of the validation group was 0.808(P<0.001),and the P values of the Hosmer-Lemeshow test of the modeling group and the validation group were both greater than 0.05. The decision curve was above the reference line within most of the high-risk thresholds. CONCLUSION The risk prediction model constructed in this study has good effect,which can predict the risk of severe RIOM during radiotherapy in patients with head and neck cancer,providing the reference for taking preventive intervention measures for high-risk patients.
