Objective  To analyze the influencing factors of cisplatin chemotherapy sensitivity in elderly patients with non-small cell lung cancer and to construct a nomogram prediction model.

Methods  A retrospective analysis was conducted on elderly patients with non-small cell lung cancer who received treatment in the Lishui People’ s Hospital from January 2018 to January 2024. Taking solid tumor efficacy evaluation standard 1.1 as the gold standard for the evaluation of chemotherapy sensitivity, the patients were divided into the cisplatin-sensitive group (complete remission/partial remission/stable disease) and the cisplatin-resistant group (disease progression or death). The independent influencing factors of cisplatin chemotherapy sensitivity in elderly patients with lung cancer were analyzed, and the nomogram and the  prediction model was constructed by R software. Additionally, the predictive value of the model was evaluated by drawing receiver operating characteristic (ROC) curve.

Results    Among 103 elderly patients with non-small cell lung cancer, 61 cases (59.22%) were sensitive to cisplatin and 42 cases (40.78%) were resistant to cisplatin. According to the multivariate analysis, the distant metastasis, hemoglobin, albumin, lymphocytes and platelets (HALP) score, cytokeratin 19 fragment (CYFRA21-1) and neutrophil-lymphocyte ratio (NLR) were independent influencing factors of cisplatin chemotherapy sensitivity (P<0.05). In the combined application, a four factor prediction model was established as Ln [P/(1-P)]=2.545+1.318×distant metastasis-0.294×HALP score+0.302×CYFRA21.1+1.958×NLR. Hosmer-Lemeshow goodness-fit test was performed on the model, with χ² of 1.879, P=0.985>0.05, and the area under the ROC curve (the consistency index) of 0.909.

Conclusion  The distant metastasis, HALP score, CYFRA21-1 and NLR are significantly correlated with the sensitivity of cisplatin chemotherapy in elderly patients with non-small cell lung cancer. The nomogram model based on the above influencing factors is helpful for early identification of patients with cisplatin chemotherapy benefit among elderly patients with lung cancer.

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