Chemotherapy intolerance in metastatic non-small cell lung cancer: the role of nutritional status

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