Effect of pre-treatment nutritional status on outcome in elderly patients with locally advanced esophageal squamous cell carcinoma undergoing radical radiotherapy
Objective To explore the impact of pre-treatment nutritional status on the outcome of elderly patients with locally advanced esophageal squamous cell carcinoma undergoing radical radiotherapy.Method A total of 96 elderly patients with locally advanced esophageal squamous cell carcinoma who received treatment at Jiangsu Cancer Hospital from May 2021 to January 2023 were selected.Prior to treatment,levels of prealbumin(PAB),hemoglobin(Hb),serum albumin(ALB),and NRS 2002 score were tested,and binary logistic regression analysis was performed to determine the prognostic factors affecting the patients.According to the patient's prognosis,they were further divided into two groups,namely the poor prognosis group(death,n=32)and the good prognosis group(survival,n=64).The levels of PAB,Hb,ALB,and NRS 2002 scores were compared between the two groups.Analyze the predictive value of PAB,Hb,ALB levels,and NRS 2002 score values through ROC curve analysis.Result 96 patients underwent serum tests before treatment,with ALB(43.86±9.86)g/L,PAB(178.95±18.53)mg/L,Hb(129.84±15.43)g/L,and NRS 2002(3.49±1.86)points.According to binary logistic regression analysis,pre-treatment ALB≤44g/L,pre-treatment PAB≤179 mg/L,pre-treatment Hb≤126 g/L,and pre-treatment NRS 2002 score>3 points are prognostic factors affecting elderly patients with locally advanced esophageal squamous cell carcinoma(P<0.05).The regression model was validated using Bootstrap method,with an AUC of 0.866 and 95%CI=0.795-0.938.Meanwhile,the ALB(52.65±8.91)g/L,PAB(189.63±19.12)mg/L,and Hb(141.58±17.21)g/L in the group with good prognosis were higher than those in the group with poor prognosis,and the NRS 2002 score(1.55±0.75)was lower than that in the group with poor prognosis(P<0.05).Through ROC analysis,the ALB,PAB,Hb,and NRS 2002 scores predicted the prognosis of elderly patients with locally advanced esophageal squamous cell carcinoma to be 0.836,0.898,0.877,and 0.914,respectively.Conclusion PAB,Hb,ALB levels and NRS 2002 score value can predict the survival prognosis of elderly patients with locally advanced esophageal squamous cell carcinoma.By testing their nutritional status before treatment,it can play an important role in the recent efficacy and survival prognosis,which is conducive to reducing mortality and improving prognosis.
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