Construction and validation of a nomogram model for predicting significant weight loss in patients with nasopharyngeal carcinoma undergoing radiotherapy
Objective To construct and validate a nomogram model for predicting significant weight loss in patients with nasopharyngeal carcinoma(NPC)undergoing intensity-modulated radiation therapy(IMRT).Methods This prospective study included 74 patients with nasopharyngeal carcinoma(NPC)who received IMRT at Shangluo Central Hospital from January 2018 to June 2023.Significant weight loss was defined as a weight loss ≥10％during radiotherapy.The patients were divided into a CWL group(34 cases)and a non-CWL group(40 cases).There were 25 males and 9 females in the CWL group;they were(48.29±8.47)years old.There were 28 males and 12 females in the non-CWL group;they were(45.79±7.69)years old.Univariate analysis was conducted on ages,body mass indexes(BMI),smoking history,pathological types,family history of tumors,and other data in both groups.Multivariate logistic regression analysis was used to identify the risk factors for significant weight loss in the patients;a nomogram prediction model was established based on the results.Calibration curves were used for the validation.t andx2tests were employed for the statistical analysis.Results There was a statistical difference in N staging of Union for International Cancer Control(UICC)between the two groups(x2=12.730,P＜0.05).The proportions of the patients using chemotherapy drugs during radiotherapy and whose Epstein-Barr virus(EBV)copy number＞1 500 copies/ml,neck radiotherapy dosage in the CWL group were higher than those in the non-CWL group[97.74％(33/34)vs.75.00％(30/40),52.63％(23/34)vs.37.50％(15/40),(70.61±2.79)Gy vs.(65.75±2.53)Gy];the levels of albumin hemoglobin,and prealbumin after the radiotherapy in the CWL group were lower than those in the non-CWL group[(37.48±3.91)g/L vs.(40.24±4.79)g/L,(109.79±16.97)g/L vs.(120.97±17.82)g/L,and(206.58±37.16)mg/L vs.(229.75±34.39)mg/L];there were statistical differences(x2=7.066 and 6.686;t=7.855,2.684,2.749,and 2.783;all P＜0.05).The multivariate logistic regression analysis revealed that high N staging,high neck radiation dosage,use of chemotherapy during radiotherapy,high EB virus copy number,and low levels of albumin,hemoglobin,and prealbumin after radiotherapy were independent risk factors for significant weight loss in the patients(all P＜0.05).The nomogram model constructed could effectively predict the occurrence of significant weight loss in the patients,and the calibration curve validation indicated a good predictive accuracy of the model.Conclusion Patients with high N staging,high neck radiation dosage,use of chemotherapy during radiotherapy,a high EB virus copy number,and low levels of albumin,hemoglobin,and prealbumin after radiotherapy have high risk of significant weight loss and should be given special attention and corresponding preventive measures during treatment.
万方数据
维普
