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Published on: July 21, 2018
Correlation between prognostic nutritional index and oral mucositis in patients with lung adenocarcinoma treated with
Simeng Gao1, Jingru Han1, Zhenlong Tian1
1Department of Oncology, Cancer Diagnosis and Therapy Research Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Abstract:
Oral mucositis (OM) is a common adverse reaction to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), and severe cases can impair patient compliance and quality of life. The prognostic nutritional index (PNI) comprehensively reflects an individual's nutritional and immune status and has been applied in lung cancer prognosis studies. However, its relationship with treatment-related OM associated with EGFR-TKI remains unclear. This study aims to investigate the correlation between PNI and the occurrence of OM in patients with lung adenocarcinoma treated with almonertinib.
Methods:
This study is a multicenter, prospective observational study. From May 2025 to September 2025, 14,039 patients were assessed for eligibility on the unified platform; 537 met the eligibility criteria and had complete baseline data for analysis. Baseline clinical and laboratory data were collected, and PNI was calculated as 5 × lymphocyte count (109/L) + serum albumin (g/L). OM occurrence was assessed at three-week intervals and graded according to the WHO scoring systems. Independent associations between PNI and OM were evaluated using logistic regression, propensity score matching (PSM), restricted cubic splines (RCS), and subgroup analyses.
Results:
During follow-up, 14.5% of patients developed OM. Multivariate logistic regression analysis showed that for each 1-unit increase in PNI, the risk of OM decreased by approximately 1.4% (OR = 0.986, 95% CI: 0.972-1.000). Trend analysis results indicate that patients with high PNI levels exhibit a significantly reduced risk of developing OM (P for trend < 0.01). The RCS model suggested a linear negative correlation between PNI and OM. Subgroup analysis results were robust, though interactions were observed across different clinical stages.
Conclusion:
Low PNI levels are independently associated with a significantly increased risk of OM. As a simple, cost-effective, and readily accessible indicator, PNI holds promise as a valuable tool for early risk stratification and personalized management in patients with EGFR-mutated lung adenocarcinoma, providing guidance for optimizing targeted therapy throughout the treatment journey.
