Aykut TURHAN, Mehmet Emin BÜYÜKBAYRAM
Anatolian Current Medical Journal - 2026;8(2):224-230
Aims: Chemotherapy intolerance is a significant clinical challenge in metastatic non-small cell lung cancer (NSCLC) treatment, affecting treatment delivery, response, and quality of life. This study aimed to assess the association between baseline nutritional indicators and chemotherapy intolerance in patients with metastatic NSCLC receiving first-line paclitaxel-carboplatin chemotherapy. Methods: In this retrospective observational study, 82 patients with histologically confirmed metastatic NSCLC treated with first-line paclitaxel-carboplatin chemotherapy were enrolled. Baseline nutritional status was assessed using serum albumin, hemoglobin, body mass index (BMI), and unintentional weight loss measurements. Chemotherapy intolerance was defined as the inability to tolerate the planned chemotherapy regimen, necessitating treatment modification, including dose reduction due to treatment-related toxicity, treatment delays of >=7 days, or temporary discontinuation because of grade 3-4 adverse events. Univariate and multivariate logistic regression analyses were performed to identify the predictors of chemotherapy intolerance. Results: Chemotherapy intolerance was observed in 35 patients (42.7%). The chemotherapy-intolerant group had significantly lower median hemoglobin (p<0.001), serum albumin (p=0.001), and BMI (p=0.009) than the chemotherapy-tolerant group. Weight loss (71.4% vs. 36.2%, p=0.002), low serum albumin (<3.5 g/dl, p=0.004), and anemia (p=0.002) were more prevalent in the chemotherapy-intolerant group. In the multivariate analysis, weight loss (odds ratio [OR]=3.28, 95% confidence interval [CI]: 1.07-10.03, p=0.039), anemia (OR=4.62, 95% CI: 1.36-15.67, p=0.014), and low serum albumin (OR=5.06, 95% CI: 1.19-21.42, p=0.030) were independently associated with chemotherapy intolerance. Conclusion: Baseline nutritional status, particularly weight loss, anemia, and hypoalbuminemia, is independently associated with chemotherapy intolerance in patients with metastatic NSCLC receiving first-line paclitaxel-carboplatin therapy. These findings highlight the importance of nutritional assessment and support in optimizing chemotherapy and patient outcomes.
