Objective To investigate the predictive value of prognostic nutritional index (PNI) and body mass index (BMI) for prognosis in patients with advanced pancreatic cancer undergoing concurrent chemoradiotherapy. Method We conducted a retrospective study on clinical data from patients with advanced pancreatic cancer who underwent concurrent chemoradiotherapy at Zhongnan Hospital of Wuhan University between January 1, 2020, and January 1, 2025. All clinical information and baseline data were collected and recorded within one week prior to the initiation of radiotherapy. The median follow-up period was 12 months, during which patient survival status was documented. Nutritional indicators primarily included PNI and BMI. The Kaplan-Meier method was used to plot survival curves for pancreatic cancer patients after concurrent chemoradiotherapy, analyzing the relationship between baseline indicators and overall survival (OS). Independent prognostic factors were identified using univariate and multivariate Cox regression models. Statistical analysis was performed using SPSS version 30.0. Result A total of 92 patients were included in this study. ROC curve analysis showed optimal cutoff values for PNI, BMI, and the combined PNI-BMI index as 42.175, 20.497, and 0.332, respectively, with corresponding areas under the curve (AUC) of 0.741, 0.642, and 0.749. Univariate Cox regression analysis revealed that receipt of multiple lines of therapy, PNI ≥ 42.175, and BMI ≥ 20.497 kg/m2 were associated with better OS, while PNI-BMI ≥ 0.332 was associated with poorer OS. Multivariate Cox regression analysis identified not having received multiple lines of therapy as an independent prognostic factor for OS, correlating with poorer survival outcomes. Kaplan-Meier survival analysis demonstrated a significantly superior median OS in the high PNI group compared to the low PNI group (median OS not reached vs. 11 months, the 1-year survival rate was 82.2% vs. 39.2%, P <0 .001). Similarly, the high BMI group had a significantly better median OS than the low BMI group (43 months vs. 12 months, the 1-year survival rate was 82.5% vs. 47.2%, P = 0.002). Conversely, the low PNI-BMI group exhibited a significantly longer median OS than the high PNI-BMI group (median OS not reached vs. 12 months, the 1-year survival rate was 84.5% vs. 47.6%, P < 0.001). Conclusion Nutritional indicators, including the Prognostic Nutritional Index (PNI), Body Mass Index (BMI), and their composite index (PNI-BMI), demonstrate prognostic value in patients with locally advanced pancreatic cancer undergoing concurrent chemoradiotherapy. As a composite indicator, PNI-BMI provides a more comprehensive assessment of patients' overall nutritional reserve than any single parameter alone.
Key words
Prognostic nutritional index /
Overall survival time /
prediction /
Advanced pancreatic cancer /
Concurrent chemoradiotherapy /
Body mass index /
Pancreatic cancer /
Prognosis
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