ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1588391
Prognostic Impact of Body Composition and Immune-nutritional Status in Oligometastatic NSCLC Patients Receiving Radiotherapy
Provisionally accepted
- 1Bengbu Medical College, Bengbu, Anhui Province, China
- 2Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Background: Metabolic and nutritional status are recognized as prognostic and predictive biomarkers in cancer treatment. However, there is limited research on oligometastatic non-small cell lung cancer (NSCLC) patients undergoing radiotherapy.We aimed to explore the independent and synergistic effects of body composition and immune-nutritional status on survival outcomes in these patients.Methods: Patients with oligometastatic NSCLC who underwent radiotherapy between 2017 and 2022 were retrospectively included. The evaluated outcomes were overall survival (OS) and progression-free survival (PFS). The skeletal muscle index (SMI), subcutaneous fat index (SFI), and pericardial fat index (PFI) were obtained using computed tomography (CT) and normalized by height squared. Laboratory biomarkers were utilized to assess immune-nutritional status. Univariate chi-square tests and multivariate logistic regression analyses were employed to determine correlations between hematological parameters and body composition. We conducted K-M analyses, along with univariate and multivariate Cox regression analyses to evaluate survival outcomes.Results: 102 patients (mean age 61.44 years, 51 males [50%]) were included.Compared to non-responders, responders exhibited a significantly lower prevalence of sarcopenia (44.93% vs 55.07%, P=0.007) and demonstrated relatively better immune-nutritional scores. Logistic regression analyses revealed that a low Prognostic Nutritional Index (PNI) was a risk factor for SMI, SFI, and PFI.Multivariate Cox analyses revealed that C reactive protein-to-albumin ratio (CAR) (HR=0.26; 95% CI 0.11-0.61; P=0.002) and PFI (HR=2.73; 95% CI 1.06-7.01; P=0.037) were predictive factors for OS. CAR (HR=0.34, P=0.001) and SFI (HR=1.82, P=0.049) were independent prognostic markers for PFS. K-M analyses indicated that the group with high PNI and high SFI exhibited markedly improved OS and PFS, as well as the one with high PNI and without sarcopenia (P<0.001).Among oligometastatic NSCLC patients receiving radiotherapy, higher skeletal muscle and fat content, along with better immune-nutritional status, correlated with improved survival outcomes.
Keywords: Body Composition, immune-nutritional scores, Oligometastasis, NSCLC, radiotherapy 1.Introduction
Received: 05 Mar 2025; Accepted: 30 May 2025.
Copyright: © 2025 Huang, Guo, Gao, Li, Yu, Zhu, He, Chen and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Haiyan Chen, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China
Hao Jiang, Bengbu Medical College, Bengbu, 233030, Anhui Province, China
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