ArticleFrontiers in nutrition2026
Nutritional risk and cancer pain as determinants of radiotherapy-induced severe lymphocytopenia: development and validation of a nutrition-integrated predictive nomogram.
Article in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Abstract
Background: Radiotherapy-induced severe lymphocytopenia (SL) represents a critical immune-related toxicity associated with poor oncologic outcomes. While treatment-related factors have been extensively studied, the contribution of baseline nutritional risk and cancer-related pain to immune vulnerability during radiotherapy remains insufficiently explored. This study aimed to evaluate the role of nutrition- and symptom-related factors in SL and develop a clinically applicable predictive model. Methods: A retrospective cohort of 97 cancer patients receiving radiotherapy in 2022 was analyzed. Nutritional risk was assessed using the Nutritional Risk Screening 2002 (NRS-2002) before radiotherapy and at mid-treatment; the pretreatment result was used as the baseline nutritional risk variable in the predictive analyses, whereas the mid-treatment assessment was used for nutritional monitoring. Cancer pain was evaluated using the Numeric Rating Scale. Logistic regression identified independent predictors of SL (lymphocyte count < 0.5 × 10 Results: Lymphocyte counts declined progressively during radiotherapy ( Conclusion: Nutritional risk and cancer pain independently contribute to radiotherapy-induced immune suppression. The proposed nutrition-integrated nomogram enables personalized immune risk assessment and supports early nutritional and symptom-targeted interventions to preserve immune competence during radiotherapy.
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