2628 - Prediction Study of Prognostic Nutrition Index on the Nausea and Vomiting of Patients with Cancer Undergoing Chemotherapy or Concurrent Chemoradiotherapy Based on Cisplatin

L. Wang, Y. Yin, G. Xiang, X. Long, J. Zang, and L. N. Zhao; Department of Radiation Oncology, Xijing Hospital, Air Force Medical University, Xian, China

Purpose/Objective(s): To explore the impact of prognostic nutritional index (PNI) on the occurrence of acute and delayed nausea and vomiting in cancer patients who underwent chemotherapy or concurrent chemoradiotherapy based on cisplatin. Materials/

Methods: A total of 299 cancer patients (84 nasopharyngeal carcinoma patients, 32 lung cancer patients, 126 cervical carcinoma patients, and 57 esophageal cancer patients) who underwent chemotherapy or chemoradiotherapy from Xijing hospital between January 2022 and December 2023 were selected as the study subjects. PNI was calculated as: [(10×serum albumin (g/dL)) + (0.005×total lymphocyte count)]. Ordinal logistic regression analysis in generalized linear models was used to study the effects of age, body mass index (BMI), Karfosky performance score (KPS), disease type, concurrent chemoradiotherapy, triple or quadruple antiemetic regimens, and PNI on acute and delayed nausea and vomiting. Taking the survival status as the endpoint, the receiver operating curve (ROC) was used to find the cutoff value of PNI, the continuous variable PNI was divided into two groups. The Kaplan-Meier method was used to draw the survival curve, and the Log-Rank test was employed to compare the survival rates of the two groups.
Results: The results of ordered logistic regression analysis showed that concurrent chemoradiotherapy was a risk factor for delayed nausea (odds ratio OR=1.605, 95% CI, 1.016-2.534, p=0.042) compared with non-concurrent chemoradiotherapy. High PNI was a protective factor for the occurrence of delayed nausea (odds ratio OR=0.965, 95% CI, 0.935-0.997, p=0.030). Lung cancer (odds ratio OR=0.183, 95% CI, 0.076- 0.438, p<0.001), cervical cancer (odds ratio OR=0.409, 95% CI, 0.241-0.695, p=0.001), and esophageal cancer (odds ratio OR=0.477, 95% CI, 0.251-0.904, p=0.023) patients are less likely to experience delayed nausea compared with patients diagnosed with nasopharyngeal carcinoma. High PNI is a protective factor for delayed vomiting (odds ratio OR=0.914, 95% CI, 0.872-0.958, p<0.001). The 3-year overall survival (OS) rate of the low PNI group was 88.9%, and the 3-year OS rate of the high PNI group was 82.0%. There was no statistical difference between the two groups (p=0.176).
Conclusion: Concurrent chemoradiotherapy is a risk factor for delayed nausea, and the incidence of delayed nausea of cancer patients with low PNI receiving chemotherapy is higher than that of patients with high PNI. Compared with patients diagnosed with nasopharyngeal cancer, patients with lung cancer, cervical cancer, and esophageal cancer are more likely to develop delayed nausea. Treatment outcomes did not differ according to the different PNI.