ArticleIntegrative cancer therapies
NUTRISCORE: A Novel Nutrition-Based Nomogram to Predict Severe Neutropenia After Adjuvant Chemotherapy in Gastric Cancer.
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Abstract
backgroundTo develop and validate a clinically applicable nomogram (NUTRISCORE) predicting severe neutropenia (Grade 3/4) across cycles 2 to 8 of adjuvant chemotherapy in gastric cancer.
methodsThis retrospective cohort study analyzed 391 patients receiving postoperative adjuvant chemotherapy (CAPEOX/XELOX/SOX) following curative laparoscopic D2 gastrectomy. Cohorts were stratified into derivation (n = 318; 1518 cycles) and validation (n = 73; 356 cycles) sets. Generalized Estimating Equations (GEE) were used to account for within-patient correlation of multiple cycles. Multivariable logistic regression identified independent predictors, with subsequent nomogram construction using R. Model performance was quantified through AUC-ROC and decision curve analysis (DCA).
resultsFour predictors emerged: age > 60 years (OR = 2.1,
conclusionsWe establish a nutrition-centric predictive tool for severe neutropenia, demonstrating robust accuracy in stratifying chemotherapy toxicity risk. This model directly informs personalized prophylactic strategies, warranting prospective multicenter validation.
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