Construction and validation of a risk prediction model for delayed chemotherapy-induced nausea and vomiting in patients with lung cancer

Yang Jie; Zhang Lin

doi:10.13406/j.cnki.cyxb.003993/h

您当前的位置：

首页 >

文章列表页 >

Construction and validation of a risk prediction model for delayed chemotherapy-induced nausea and vomiting in patients with lung cancer

Precision medicine in cancer and translational studies | 更新时间：2026-03-19

- Construction and validation of a risk prediction model for delayed chemotherapy-induced nausea and vomiting in patients with lung cancer
- Journal of Chongqing Medical University Vol. 51, Issue 3, Pages: 362-367(2026)
- 作者机构：
  
  郑州大学附属肿瘤医院/河南省肿瘤医院呼吸内科，郑州　450008
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003993/h
  CLC： R734.2
- Received：17 April 2025，
  
  Revised：2025-06-25，
  
  Accepted：04 July 2025，
  
  Published：28 March 2026
- 稿件说明：
移动端阅览
杨洁,张琳.肺癌化疗患者延迟性呕吐风险预测模型构建与验证[J].重庆医科大学学报,2026,51(03):362-367.

Yang Jie,Zhang Lin.Construction and validation of a risk prediction model for delayed chemotherapy-induced nausea and vomiting in patients with lung cancer[J].Journal of Chongqing Medical University,2026,51(03):362-367.
杨洁,张琳.肺癌化疗患者延迟性呕吐风险预测模型构建与验证[J].重庆医科大学学报,2026,51(03):362-367. DOI： 10.13406/j.cnki.cyxb.003993/h.

Yang Jie,Zhang Lin.Construction and validation of a risk prediction model for delayed chemotherapy-induced nausea and vomiting in patients with lung cancer[J].Journal of Chongqing Medical University,2026,51(03):362-367. DOI： 10.13406/j.cnki.cyxb.003993/h.

摘要

目的

筛选肺癌化疗患者延迟性呕吐（chemotherapy-induced nausea and vomiting，CINV）的关键影响因素，构建并验证延迟性CINV风险预测模型。

方法

回顾性分析2023年4月至2024年12月就诊于河南省肿瘤医院的150例肺癌化疗患者的临床资料。统计所有患者首次化疗结束后延迟性CINV的发生情况，将其分为阳性组（CINV组）和阴性组（非CINV组）；Logistic回归分析筛选延迟性CINV的独立危险因素；根据筛选结果构建预测对应列线图模型；绘制受试者工作特征（receiver operating characteristic，ROC）曲线以及校准曲线评估该模型的预测价值和拟合度。

结果

150例患者中共发生53例延迟性CINV，纳入阳性组；其余97例患者未发生延迟性CINV，纳入阴性组。logistic回归模型显示，化疗前卡氏功能状态（Karnofsky performance status，KPS）评分（

=0.556，95%CI=0.363~0.851）、胃4 h排空率（

=0.431，95%CI=0.223~0.833）、化疗前胃肠道症状评定量表（gastrointestinal symptom rating scale，GSRS）评分（

=0.633，95%CI=0.431~0.929）是肺癌化疗患者发生延迟性CINV的保护因素（

0.05），抑郁-焦虑-压力量表（depression-anxiety-stress scale，DASS-21）评分（

=3.997，95%CI=1.527~10.464）是危险因素（

0.05）。以上述分析结果为基础，构建预测肺癌化疗患者发生延迟性CINV的列线图模型；ROC曲线分析显示该模型预测肺癌化疗患者发生延迟性CINV的曲线下面积（area under the curve，AUC）为0.821，95%CI=0.750~0.879；同时，校准曲线结果显示，该列线图模型拟合度良好。

结论

化疗前KPS评分、胃4 h排空率、GSRS评分是肺癌化疗患者发生延迟性CINV的保护因素，DASS-21评分是危险因素，基于此构建的列线图模型具有良好的预测效能。

Abstract

Objective

To determine the key influencing factors for delayed chemotherapy-induced nausea and vomiting（CINV） in patients with lung cancer，and to construct and validate a risk prediction model for delayed CINV.

Methods

We retrospectively analyzed the clinical data of 150 patients with lung cancer treated at Henan Cancer Hospital from April 2023 to December 2024. According to whether delayed CINV occurred after the first chemotherapy，the patients were divided into CINV group and non-CINV group. The independent risk factors for delayed CINV were determined through a logistic regression analysis，and the significant factors were used to construct a nomogram model. The receiver operating curve（ROC） and calibration curve were used to evaluate the predictive value and goodness of fit of the model，respectively.

Results

Among the 150 patients，delayed CINV was present in 53 patients（CINV group） and absent in the remaining 97 patients（non-CINV group）. The logistic regression model showed that pre-chemotherapy Karnofsky performance status（KPS） score（odds ratio［

］=0.556，95%CI=0.363-0.851，

0.05），4-hour gastric emptying rate（

=0.431，95%CI=0.223-0.833，

0.05），and Gastrointestinal Symptom Rating Scale（GSRS） score（

=0.633，95%CI=0.431-0.929，

0.05） were protective factors against delayed CINV，while the Depression-Anxiety-Stress Scale（DASS-21） score（

=3.997，95%CI=1.527-10.464，

0.05） was a risk factor for delayed CINV in patients with lung cancer. For the nomogram model predicting delayed CINV in patients with lung cancer based on the above variables，the area under the ROC curve was 0.821（95%CI=0.750-0.879），and the calibration curve indicated that the nomogram model exhibited a high goodness of fit.

Conclusion

KPS score，4-hour gastric emptying rate，and GSRS score before chemotherapy are protective factors against delayed CINV，while DASS-21 score is a risk factor for delayed CINV in patients with lung cancer. The nomogram model based on them exhibits favorable predictive performance.

关键词

Keywords

references

Abe M ， Yamaguchi T ， Fujita Y ， et al . Efficacy of olanzapine in addition to standard triplet antiemetic therapy for cisplatin-based chemotherapy：a secondary analysis of the J-FORCE randomized clinical trial [J ] . JAMA Netw Open ， 2023 ， 6 （ 5 ）： e2310894 ．

Shen GS ， Ren DF ， Zhao FX ， et al . Effect of adding electroacupuncture to standard triple antiemetic therapy on chemotherapy-induced nausea and vomiting：a randomized controlled clinical trial [J ] . J Clin Oncol ， 2024 ， 42 （ 34 ）： 4051 - 4059 ．

Gowda N ， Ravichandran M ， Indrajithu J ， et al . Addition of thalidomide for prevention of chemotherapy-induced nausea and vomiting in the second cycle after the failure of four-drug regimen in the first cycle [J ] . Med Oncol ， 2025 ， 42 （ 4 ）： 121 ．

Gao A ， Guan SS ， Sun YJ ， et al . Prolonged usage of fosaprepitant for prevention of delayed chemotherapy-induced nausea and vomiting（CINV） in patients receiving highly emetogenic chemotherapy [J ] . BMC Cancer ， 2023 ， 23 （ 1 ）： 609 ．

Crichton M ， Marshall S ， Isenring E ， et al . Effect of a standardized ginger root powder regimen on chemotherapy-induced nausea and vomiting：a multicenter，double-blind，placebo-controlled randomized trial [J ] . J Acad Nutr Diet ， 2024 ， 124 （ 3 ）： 313 - 330 ．

Shen J ， Zhao J ， Jin GW ， et al . A prospective randomized controlled clinical trial investigating the efficacy of low-dose olanzapine in preventing nausea and vomiting associated with oxaliplatin-based and irinotecan-based chemotherapy [J ] . J Cancer Res Clin Oncol ， 2024 ， 150 （ 5 ）： 283 ．

中华医学会肿瘤学分会，中华医学会杂志社 . 中华医学会肿瘤学分会肺癌临床诊疗指南（2021版） [J ] . 中华医学杂志， 2021 ， 101 （ 23 ）： 1725 - 1757 .

Chinese Society of Clinical Oncology ， Chinese Medical Association Press . Oncology Society of Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer（2021 edition） [J ] . Natl Med J China ， 2021 ， 101 （ 23 ）： 1725 - 1757 .

Edge SB ， Compton CC . The American joint committee on cancer：the 7th edition of the AJCC cancer staging manual and the future of TNM [J ] . Ann Surg Oncol ， 2010 ， 17 （ 6 ）： 1471 - 1474 ．

Tsien CI ， Pugh SL ， Dicker AP ， et al . NRG oncology/RTOG1205：a randomized phase Ⅱ trial of concurrent bevacizumab and reirradiation versus bevacizumab alone as treatment for recurrent glioblastoma [J ] . J Clin Oncol ， 2023 ， 41 （ 6 ）： 1285 - 1295 ．

Singh G ， Dixit I ， Kalman D ， et al . A novel herbal composition alleviates functional constipation，reduces gastrointestinal transit time，and improves bowel function in adults：a double-blind，randomized clinical study [J ] . J Am Nutr Assoc ， 2024 ， 43 （ 6 ）： 553 - 566 ．

Almassri HF ， Kadir AA ， Srour M ， et al . The effects of omega-3 fatty acids and vitamin D supplementation on the nutritional status of women with breast cancer in Palestine：an open-label randomized controlled trial [J ] . Nutrients ， 2024 ， 16 （ 22 ）： 3960 ．

Osman A ， Wong JL ， Bagge CL ， et al . The depression anxiety stress scales-21（DASS-21）：further examination of dimensions，scale reliability，and correlates [J ] . J Clin Psychol ， 2012 ， 68 （ 12 ）： 1322 - 1338 ．

Chandra Shekhar H ， Joshua L ， Thomas JV . Standardized extract of Valeriana officinalis improves overall sleep quality in human subjects with sleep complaints：a randomized，double-blind，placebo-controlled，clinical study [J ] . Adv Ther ， 2024 ， 41 （ 1 ）： 246 - 261 ．

Zhou HQ ， Zhao YY ， Zhang MJ ， et al . Randomized，phase Ⅲ trial of mixed formulation of fosrolapitant and palonosetron（HR20013） in preventing cisplatin-based highly emetogenic chemotherapy-induced nausea and vomiting：profit [J ] . J Clin Oncol ， 2025 ， 43 （ 9 ）： 1123 - 1136 ．

Kobayashi M ， Kako J ， Iba A ， et al . Non-pharmacological treatments for anticipatory nausea and vomiting during chemotherapy：a systematic review and meta-analysis of the Clinical Practice Guidelines for Antiemesis 2023 [J ] . Int J Clin Oncol ， 2024 ， 29 （ 7 ）： 889 - 898 ．

An Y ， Zhang ZW ， Gu M ， et al . Low dose olanzapine in the prevention and treatment of carboplatin induced nausea and vomiting：a prospective clinical randomized controlled trial [J ] . Curr Pharm Des ， 2023 ， 29 （ 23 ）： 1867 - 1874 ．

Xiao Q ， Liu TT ， Li JW ， et al . Auriculotherapy may help to reduce gastrointestinal reactions and improve quality of life post chemotherapy [J ] . Explore （NY）， 2025 ， 21 （ 2 ）： 103129 ．

Liu YH ， Hu PP ， Jiang YY ， et al . Low dose of dexamethasone combined with netupitant and palonosetron in preventing nausea and vomiting in breast cancer patients induced by anthracycline drugs [J ] . Clin Transl Oncol ， 2025 ， 27 （ 2 ）： 785 - 789 ．

Johns T ， Lawrence E . Evaluation and treatment of nausea and vomiting in adults [J ] . Am Fam Physician ， 2024 ， 109 （ 5 ）： 417 - 425 ．

林昌伟，陈顺楷，胡桂，等 . 多穴位针刺治疗促进结直肠癌患者术后胃肠功能恢复的前瞻性随机对照研究 [J ] . 中国普通外科杂志， 2024 ， 33 （ 9 ）： 1507 - 1516 .

Lin CW ， Chen SK ， Hu G ， et al . Multi-acupuncture point stimulation for promoting postoperative gastrointestinal function recovery in colorectal cancer patients：a prospective randomized controlled trial [J ] . Chin J Gen Surg ， 2024 ， 33 （ 9 ）： 1507 - 1516 .

Zhao YY ， Zhao B ， Chen G ， et al . Validation of different personalized risk models of chemotherapy-induced nausea and vomiting：results of a randomized，double-blind，phase Ⅲ trial of fosaprepitant for cancer patients treated with high-dose cisplatin [J ] . Cancer Commun（Lond）， 2023 ， 43 （ 2 ）： 246 - 256 ．

Li X ， Dong LL . The intervention effect of psychological care combined with ondansetron，dexamethasone，and promethazine hydrochloride on chemotherapy in breast cancer surgical patients [J ] . Technol Health Care ， 2024 ， 32 （ 6 ）： 5047 - 5063 ．

Jin YL ， Chen F ， Zhao J ， et al . A randomized trial evaluating the association between related gene polymorphism and nausea and vomiting induced by cisplatin multi-day chemotherapy [J ] . BMC Med Genomics ， 2023 ， 16 （ 1 ）： 276 ．

Michel-Cherqui M ， Ma S ， Bacrie J ， et al . Auriculotherapy and acupuncture treatments for chemotherapy-induced nausea and vomiting：a multicenter clinical trial [J ] . Support Care Cancer ， 2024 ， 32 （ 8 ）： 560 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Educational needs for prevention of adverse events due to immunotherapy in patients with lung cancer after neoadjuvant therapy: A single-center observational study

Establishment and validation of a nomogram prediction model for cognitive impairment in patients with hypertension based on the CHARLS database

Role of lidocaine in assisting the treatment of different types of tumor： basic and clinical evidence

Related Author

Yang Jie

Zhang Lin

Tian Xu

Tang Ling

Liu Xiaoling

Tang Rongying

Pi Yuanping

Chen Weiqing

Related Institution

The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital

Department of Nursing,Chongqing University Cancer Hospital

Department of Gastroenterology,Chongqing University Cancer Hospital

Department of Thoracic Surgery，The Second Affiliated Hospital of Air Force Medical University

Department of Cardiology， Xinqiao Hospital Affiliated to Army Medical University

⁰