Sex-specific nutritional and inflammatory trajectories during first-line chemotherapy in older adults with advanced non-small cell lung cancer.

Authors

Jinxian He, Mingjie Gu, Zhimei Chen, Jiahui Fu, Jian Yu

Published in

Frontiers in nutrition. Volume 13. Pages 1885061. Epub Aug 03, 2026.

Abstract

Malnutrition and systemic inflammation are closely interrelated determinants of treatment tolerance and prognosis in older adults with advanced non-small cell lung cancer. However, their sex-specific longitudinal patterns during chemotherapy remain insufficiently characterized. This study aimed to describe and compare sex-specific trajectories of nutritional status and systemic inflammation during first-line chemotherapy and to explore their longitudinal association from a clinical nutrition perspective.
This retrospective longitudinal cohort study included 323 patients aged 60 years or older with stage IIIB-IV non-small cell lung cancer who completed six cycles of first-line chemotherapy. Nutritional status and systemic inflammation were assessed at baseline and before each chemotherapy cycle using the Geriatric Nutritional Risk Index (GNRI) and the Systemic Inflammation Response Index (SIRI), respectively. Sex-specific trajectories were examined using linear mixed-effects models including time, sex, and time-by-sex interaction terms. Sex-stratified multivariable linear regression was then used to evaluate the association between overall changes in GNRI and SIRI after adjustment for tumor stage and histology.
Significant time-by-sex interactions were observed for both GNRI (P = 0.019) and SIRI (P = 0.002). In male patients, mean GNRI increased progressively across chemotherapy cycles, while mean SIRI decreased over time. Greater reductions in SIRI were independently associated with greater improvements in GNRI (β = -0.224, P < 0.001). In female patients, baseline GNRI was higher and remained largely within the no-risk range throughout treatment, whereas SIRI fluctuated without a clear directional trend. No significant association between overall GNRI and SIRI changes was identified in women (P = 0.626).
Sex-stratified analyses suggested differential longitudinal relationship between nutritional risk and systemic inflammation during chemotherapy in older adults with advanced non-small cell lung cancer,though formal interaction testing did not confirm statistical significance of this difference. In men, inflammatory monitoring may provide a useful adjunct to nutritional risk assessment. In women, nutritional monitoring may need to focus more on short-term changes in intake, body weight, and treatment-related symptoms than on inflammatory indices alone. These findings support further investigation of sex-informed supportive care strategies in clinical nutrition practice.

PMID:
42609203
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.