Analysis of risk factors of pulmonary infection in patients with lung cancer after chemoradiotherapy and construction of risk prediction nomograph model
OBJECTIVE To explore the influencing factors of pulmonary infection in patients with lung cancer after radiotherapy and chemotherapy,and to construct a risk prediction column chart model.METHODS A total of 198 patients with lung cancer admitted to the Affiliated Jiangning Hospital of Nanjing Medical University from May 2019 to Oct 2022 received radiotherapy and chemotherapy treatment were recruited in the study.They were divid-ed into the infection group(73 cases)and non-infection group(125 cases)according to whether pulmonary infec-tion occurred during the radiotherapy and chemotherapy period.Potential influencing factors were screened by LASSO regression analysis,and the influencing factors of pulmonary infection in patients were analyzed by logistic regression analysis.The column chart model is constructed using the"rms"package of R4.2.6 language,and the discrimination,calibration,and effectiveness of the model are evaluated by receiver operating characteristic(ROC)curves,calibration curves,and decision curves.RESULTS Ten potential influencing factors was analyzed by LASSO regression model,including the history of diabetes,serum albumin(ALB),hemoglobin(HGB),more than four cycles of radiotherapy and chemotherapy,more than two kinds of radiotherapy and chemotherapy drugs,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),use of antibiotics,atelectasis and functional status score of tumor patients＜80 points.Multivariate logistic regression analysis showed that ALB,HGB,radiotherapy and chemotherapy cycles＞4 times,use of antibiotics,NLR,and PLR were independ-ent influencing factors for the occurrence of pulmonary infection in lung cancer patients undergoing radiotherapy and chemotherapy(P＜0.05).The column chart model was built based on six influencing factors and the ROC curve showed that the AUC value of the model was 0.904(95％CI:0.865-0.997),with the consistency index of 0.963.The calibration curve of the model was close to the ideal curve.The decision curve indicated that the model had superior predictive value when the probability of prediction was between 0.381 and 0.922.CONCLUSION The influencing factors of pulmonary infection in lung cancer patients undergoing radiotherapy and chemotherapy in-clude ALB,HGB,more than 4 cycles of radiotherapy and chemotherapy,use of antibiotics,NLR,PLR,etc.The constructed column chart model has good efficacy in predicting the occurrence of pulmonary infection in lung canc-er patients undergoing radiotherapy and chemotherapy.
Chemoradiotherapy for lung cancerPulmonary infectionInfluencing factorLogistic regression anal-ysisNomograph model
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