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Background <p>Malnutrition in older non-small cell lung cancer (NSCLC) patients undergoing chemotherapy correlates with poor outcomes. While nutritional risk is dynamic, longitudinal trajectory patterns remain uncharacterized in this population.</p> Objectives <p>The present study aimed to explore the trajectory subgroups and influencing factors of nutrition-related risk over time among older adults with advanced NSCLC undergoing first-line chemotherapy.</p> Design <p>A retrospective longitudinal study.</p> Methods <p>In total, 353 patients aged &gt; 60 years who were diagnosed with advanced NSCLC and received at least six cycles of chemotherapy at a single tertiary oncology center between January 2022 and June 2024 were enrolled in this study. Nutrition-related risk was assessed with Geriatric Nutritional Risk Index (GNRI). The trajectory subgroups of nutrition-related risk over time were analyzed using the latent class growth modeling (LCGM). An unordered multi-class logistic regression analysis was performed to find the influencing factors of different trajectories.</p> Results <p>The average age of 353 patients was (68.2 ± 6.1) years, among which 272 (77.1%) were male. According to LCGM, the three categories of nutrition-related risk trajectories were identified, which were stable low risk group (<i>n</i> = 188, 53.3%), improving moderate risk group (<i>n</i> = 124, 35.1%), and persistent high to moderate risk group (<i>n</i> = 41, 11.6%). Unordered multi-class logistic regression analysis showed that age, smoking status, and hypertension were associated with the trajectory categories of nutrition-related risks.</p> Conclusions <p>Nutrition risk follows distinct trajectories during chemotherapy cycles, with 11.6% of older adults with NSCLC exhibiting sustained high vulnerability. Older age, smoking history, and hypertension are key predictors of this adverse trajectory. Assessment of these readily available and easily accessible clinical factors at treatment initiation may enable early identification of high-risk patients for targeted nutritional interventions.</p>

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Trajectory subgroups and influencing factors of nutrition-related risk in older NSCLC patients undergoing chemotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月19日

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  • Jufeng Zhang,
  • Mingjie Gu,
  • Zhimei Chen,
  • Jiahui Fu,
  • Jian Yu

摘要

Background

Malnutrition in older non-small cell lung cancer (NSCLC) patients undergoing chemotherapy correlates with poor outcomes. While nutritional risk is dynamic, longitudinal trajectory patterns remain uncharacterized in this population.

Objectives

The present study aimed to explore the trajectory subgroups and influencing factors of nutrition-related risk over time among older adults with advanced NSCLC undergoing first-line chemotherapy.

Design

A retrospective longitudinal study.

Methods

In total, 353 patients aged > 60 years who were diagnosed with advanced NSCLC and received at least six cycles of chemotherapy at a single tertiary oncology center between January 2022 and June 2024 were enrolled in this study. Nutrition-related risk was assessed with Geriatric Nutritional Risk Index (GNRI). The trajectory subgroups of nutrition-related risk over time were analyzed using the latent class growth modeling (LCGM). An unordered multi-class logistic regression analysis was performed to find the influencing factors of different trajectories.

Results

The average age of 353 patients was (68.2 ± 6.1) years, among which 272 (77.1%) were male. According to LCGM, the three categories of nutrition-related risk trajectories were identified, which were stable low risk group (n = 188, 53.3%), improving moderate risk group (n = 124, 35.1%), and persistent high to moderate risk group (n = 41, 11.6%). Unordered multi-class logistic regression analysis showed that age, smoking status, and hypertension were associated with the trajectory categories of nutrition-related risks.

Conclusions

Nutrition risk follows distinct trajectories during chemotherapy cycles, with 11.6% of older adults with NSCLC exhibiting sustained high vulnerability. Older age, smoking history, and hypertension are key predictors of this adverse trajectory. Assessment of these readily available and easily accessible clinical factors at treatment initiation may enable early identification of high-risk patients for targeted nutritional interventions.