CT-Based Sarcopenic Nomogram for Predicting Progressive Disease in Advanced Non-Small-Cell Lung Cancer

Area of Science:

• Radiology and Oncology
• Medical Imaging
• Cancer Research

Background:

• Identifying risk for progressive disease (PD) is crucial for non-small-cell lung cancer (NSCLC) patients receiving platinum-based chemotherapy.
• Sarcopenia, assessed via imaging, is a potential indicator of treatment response and prognosis.

Purpose of the Study:

• To develop and validate a computed tomography (CT) imaging-based sarcopenic nomogram.
• To predict the risk of PD in NSCLC patients before initiating chemotherapy.

Main Methods:

• Retrospective enrollment of NSCLC patients undergoing platinum-based chemotherapy.
• Sarcopenia assessment using skeletal muscle index (SMI) from pre-chemotherapy T11 CT images.
• Construction and validation of a predictive nomogram using logistic regression and performance metrics (AUC, calibration, decision curves).

Main Results:

• 60 out of 408 patients (14.7%) developed PD.
• The sarcopenic nomogram demonstrated moderate predictive efficiency with an AUC of 0.75 (training) and 0.76 (validation).
• Good calibration and favorable clinical utility were confirmed by decision curve analysis.

Conclusions:

• A CT-based sarcopenic nomogram shows potential for individualized prediction of PD in NSCLC patients.
• This tool may aid in personalizing chemotherapy treatment strategies for NSCLC.
• Further validation is warranted to integrate this nomogram into clinical practice.