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

Xiaoping Yi; Qiurong Chen; Jingying Yang; Dengke Jiang; Liping Zhu; Haipeng Liu; Peipei Pang; Feiyue Zeng; Changyong Chen; Guanghui Gong; Hongling Yin; Bin Li; Bihong T Chen

doi:10.3389/fonc.2021.643941

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

Front Oncol. 2021 Oct 8:11:643941. doi: 10.3389/fonc.2021.643941. eCollection 2021.

Authors

Xiaoping Yi^{1

2

3

4}, Qiurong Chen^{5

6}, Jingying Yang^{6

7}, Dengke Jiang⁸, Liping Zhu^{1

2}, Haipeng Liu^{1

2}, Peipei Pang⁹, Feiyue Zeng¹, Changyong Chen¹, Guanghui Gong¹⁰, Hongling Yin¹⁰, Bin Li¹¹, Bihong T Chen¹²

Affiliations

¹ Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
² National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha, China.
³ Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Changsha, China.
⁴ Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Changsha, China.
⁵ State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
⁶ Xiangya School of Medicine, Central South University, Changsha, China.
⁷ Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
⁸ Department of Radiology, the Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China.
⁹ Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, China.
¹⁰ Department of Pathology, Xiangya Hospital, Central South University, Changsha, China.
¹¹ Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
¹² Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, United States.

Abstract

Background: It is prudent to identify the risk for progressive disease (PD) in patients with non-small-cell lung cancer (NSCLC) who undergo platinum-based chemotherapy. The present study aimed to develop a CT imaging-based sarcopenic nomogram for predicting the risk of PD prior to chemotherapy treatment.

Methods: We retrospectively enrolled patients with NSCLC who underwent platinum-based chemotherapy. Imaging-based body composition parameters such as skeletal muscle index (SMI) for assessment of sarcopenia were obtained from pre-chemotherapy chest CT images at the level of the eleventh thoracic vertebral body (T11). Sarcopenic nomogram was constructed using multivariate logistic regression and performance of the nomogram was evaluated by discrimination, calibration curve, and decision curve.

Results: Sixty (14.7%) of the 408 patients in the study cohort developed PD during chemotherapy. The prediction nomogram for developing PD achieved a moderate efficiency with an area under the curve (AUC) of 0.75 (95% CI: 0.69-0.80) for the training cohort, and 0.76 (95%CI: 0.68-0.84) for the validation cohort, as well as a good performance of consistence (bootstrap for training cohort: 0.75 ± 0.02; validation cohort: 0.74 ± 0.06). Favorable clinical application was observed in the decision curve analysis.

Conclusion: Our CT-based sarcopenic nomogram showed the potential for an individualized prediction of progression for patients with NSCLC receiving platinum-based chemotherapy.

Keywords: body composition; non-small-cell lung cancer; platinum-based chemotherapy; progressive disease; sarcopenia.