{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:22:00Z","timestamp":1787610120847,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"crossref","award":["252102310103"],"award-info":[{"award-number":["252102310103"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Key Scientific Research Project of Henan Higher Education Institutions","award":["25A330007"],"award-info":[{"award-number":["25A330007"]}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022ZD0160704"],"award-info":[{"award-number":["2022ZD0160704"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Background<\/jats:title>\n Malnutrition is prevalent in individuals with gastroenteric malignancies and may negatively influence chemotherapy tolerance. This investigation evaluated the relationships between pre-treatment nutritional status and chemotherapy-derived toxicity utilizing anthropometric, biochemical, and composite nutritional indices.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective analysis was conducted involving 720 individuals with histologically verified advanced or metastatic gastroenteric malignancies, including 360 gastric cancer cases and 360 colorectal cancer cases, who were given systemic cytotoxic chemotherapy between 2017 and 2023. Baseline nutritional status was examined via body mass index (BMI), serum albumin, Prognostic Nutritional Index (PNI), and Nutritional Risk Index (NRI). Chemotherapy-associated toxicities were graded based on the CTCAE criteria. Multivariable logistic regression models were built individually by cancer type and toxicity category.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Hematological toxicity was reported in 49.7% of gastric cancer and 63.1% of colorectal cancer subjects, while non-hematological toxicity occurred in 38.1 and 56.1%, respectively. In gastric cancer, underweight status significantly elevated the possibility of hematological toxicity (OR 1.97, 95% CI 1.06\u20133.64;\n p<\/jats:italic>\n \u202f=\u202f0.03), as did hypoalbuminemia (OR 1.71, 95% CI 1.11\u20132.62;\n p<\/jats:italic>\n \u202f=\u202f0.01) and PNI\u202f\u2264\u202f45 (OR 1.70, 95% CI 1.11\u20132.61;\n p<\/jats:italic>\n \u202f=\u202f0.01). Age was independently linked with non-hematological damage (OR 1.03 per year, 95% CI 1.01\u20131.06;\n p<\/jats:italic>\n \u202f=\u202f0.001). In colorectal cancer, age individually indicated both hematological (OR 1.03 per year;\n p<\/jats:italic>\n \u202f=\u202f0.001) and non-hematological harm (OR 1.04 per year;\n p<\/jats:italic>\n \u202f=\u202f0.001). Lower BMI (OR 2.00, 95% CI 1.02\u20133.91;\n p<\/jats:italic>\n \u202f=\u202f0.04), hypoalbuminemia (OR 1.85, 95% CI 1.12\u20133.04;\n p<\/jats:italic>\n \u202f=\u202f0.01), PNI\u202f\u2264\u202f45 (OR 1.90, 95% CI 1.21\u20132.97;\n p<\/jats:italic>\n \u202f=\u202f0.005), and NRI\u202f\u2264\u202f83 (OR 2.50, 95% CI 1.29\u20134.85;\n p<\/jats:italic>\n \u202f=\u202f0.007) individually determined hematological injury, while hypoalbuminemia (OR 1.90;\n p<\/jats:italic>\n \u202f=\u202f0.01) and NRI\u202f\u2264\u202f83 (OR 2.35;\n p<\/jats:italic>\n \u202f=\u202f0.01) were also linked with non-hematological damage.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Pre-treatment nutritional inadequacy was connected with chemotherapy toxicity, which supports periodic nutritional screening prior to medication.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1780440","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:35:43Z","timestamp":1781152543000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between pre-treatment malnutrition and chemotherapy toxicity in patients with advanced or metastatic gastroenteric tumors receiving systemic therapy"],"prefix":"10.3389","volume":"13","author":[{"given":"Yadong","family":"Dong","sequence":"first","affiliation":[{"name":"National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiaoQiang","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Computer and Artificial Intelligence, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Ma","sequence":"additional","affiliation":[{"name":"National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongqing","family":"Liu","sequence":"additional","affiliation":[{"name":"National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyuan","family":"Li","sequence":"additional","affiliation":[{"name":"National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Engineering Laboratory for Internet Medical Systems and Applications, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]},{"name":"Institute of Intelligent Medicine, Henan Academy of Innovations in Medical Science","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1038\/s41430-020-0629-0","article-title":"Relationship between markers of malnutrition and clinical outcomes in older adults with cancer: systematic review, narrative synthesis and meta-analysis","volume":"74","author":"Bullock","year":"2020","journal-title":"Eur J Clin Nutr"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1016\/j.jgo.2022.06.010","article-title":"Associations between outcome variables of nutritional screening methods and systemic treatment tolerance in patients with colorectal cancer: a systematic review","volume":"13","author":"Beukers","year":"2022","journal-title":"J. Geriat. Oncol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1002\/cncr.32718","article-title":"Associations between nutritional factors and chemotherapy toxicity in older adults with solid tumors","volume":"126","author":"Dotan","year":"2020","journal-title":"Cancer"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e2339116","DOI":"10.1001\/jamanetworkopen.2023.39116","article-title":"Chemotherapy-related toxic effects and quality of life and physical functioning in older patients","volume":"6","author":"Baltussen","year":"2023","journal-title":"JAMA Netw Open"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1186\/s12885-016-2934-5","article-title":"Association of nutritional status-related indices and chemotherapy-induced adverse events in gastric cancer patients","volume":"16","author":"Seo","year":"2016","journal-title":"BMC Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1186\/s12876-024-03548-6","article-title":"Impact of nutrition risk index, prognostic nutritional index and skeletal muscle index on early myelosuppression of first-line chemotherapy in stage IV gastric cancer patients","volume":"24","author":"Wei","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1177\/1078155220959427","article-title":"Does nutritional status affect treatment tolarability, response and survival in metastatic colorectal cancer patients? Results of a prospective multicenter study","volume":"27","author":"Karabulut","year":"2021","journal-title":"J Oncol Pharm Pract"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.ejca.2019.07.011","article-title":"Evaluation of two nutritional scores' association with systemic treatment toxicity and survival in metastatic colorectal cancer: an AGEO prospective multicentre study","volume":"119","author":"Gallois","year":"2019","journal-title":"Eur J Cancer"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"170","DOI":"10.4103\/jnsm.jnsm_99_20","article-title":"Malnutrition in cancer patients receiving chemotherapy in a single oncology center","volume":"4","author":"Alsaleh","year":"2021","journal-title":"J Nat Sci Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.1186\/s12885-025-14571-5","article-title":"Assessment of nutritional status of patients receiving chemotherapy: sample from European Gaza hospital","volume":"25","author":"El-Najjar","year":"2025","journal-title":"BMC Cancer"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1002\/jpen.2251","article-title":"Validation of the scored patient-generated subjective global assessment short form as a prognostic tool for incurable cancer patients","volume":"46","author":"Cunha","year":"2022","journal-title":"J Parenter Enter Nutr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2597","DOI":"10.3390\/cancers16142597","article-title":"Chemotoxicity and associated risk factors in colorectal cancer: a systematic review and meta-analysis","volume":"16","author":"Han","year":"2024","journal-title":"Cancer"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1007\/s00520-024-08556-6","article-title":"Influence of malnutrition according to the glim criteria on the chemotherapy toxicities in patients with advanced lung cancer","volume":"32","author":"Li","year":"2024","journal-title":"Support Care Cancer"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1676201","DOI":"10.3389\/fnut.2025.1676201","article-title":"Association between malnutrition diagnosed by different screening and asscessment tools and clinical outcomes: an umbrella review","volume":"12","author":"Li","year":"2025","journal-title":"Front Nutr"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-025-01777-6","article-title":"Evaluating the role of dietary interventions in reducing chemotherapy toxicities in cancer patients: a systematic review","author":"Abene","year":"2025","journal-title":"Journal of cancer survivorship: research and practice"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.3390\/pharmaceutics17111443","article-title":"Impact of Oral nutrition supplements in gastrointestinal Cancer patients: a randomized controlled trial","volume":"17","author":"Sarhan","year":"2025","journal-title":"Pharmaceutics"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"4670","DOI":"10.3390\/cancers15184670","article-title":"Predicting risk of severe toxicity and early death in older adult patients treated with chemotherapy","volume":"15","author":"Feliu","year":"2023","journal-title":"Cancer"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"86","DOI":"10.21037\/apm.2018.08.02","article-title":"Sarcopenia associated with chemotherapy and targeted agents for cancer therapy","volume":"8","author":"Davis","year":"2019","journal-title":"Ann Palliat Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"711","DOI":"10.3390\/jcm14030711","article-title":"Could sarcopenia be related to chemotherapy in gastrointestinal Cancer? A cross-sectional study including comprehensive geriatric assessment","volume":"14","author":"S\u0131lay","year":"2025","journal-title":"J Clin Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1117232","DOI":"10.3389\/fimmu.2023.1117232","article-title":"The prognostic effect of sixteen malnutrition\/inflammation-based indicators on the overall survival of chemotherapy patients","volume":"14","author":"Liu","year":"2023","journal-title":"Front Immunol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"519","DOI":"10.3390\/curroncol32090519","article-title":"Nutritional status and chemotherapy completion in Resectable pancreatic Cancer: a narrative review","volume":"32","author":"Funamizu","year":"2025","journal-title":"Curr Oncol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1080\/01635581.2024.2437833","article-title":"Diet as an adjunct therapy in reducing chemotherapy toxicities and improving patients quality of life: a systematic review and Meta-analysis","volume":"77","author":"Abene","year":"2025","journal-title":"Nutr Cancer"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"80","DOI":"10.3390\/cancers18010080","article-title":"Risk of malnutrition in digestive system cancers: a systematic review and meta-analysis","volume":"18","author":"Budai","year":"2025","journal-title":"Cancer"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.3390\/cancers16061232","article-title":"Quality of life, sarcopenia and nutritional status in patients with esophagogastric tumors before and after neoadjuvant therapy","volume":"16","author":"Schooren","year":"2024","journal-title":"Cancer"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1605421","DOI":"10.3389\/fnut.2025.1605421","article-title":"Association between prognostic nutritional index and myelosuppression in gastric cancer patients undergoing chemotherapy: a retrospective cohort study","volume":"12","author":"Chen","year":"2025","journal-title":"Front Nutr"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-025-01747-y","article-title":"Global prevalence and moderating factors of malnutrition in colorectal cancer survivors: A meta-analysis","author":"Arifin","year":"2025","journal-title":"Journal of cancer survivorship: research and practice"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1002\/jso.27488","article-title":"Impact of malnutrition on cancer recurrence, colorectal cancer-specific death, and non-colorectal cancer-related death in patients with colorectal cancer who underwent curative surgery","volume":"129","author":"Nakamura","year":"2024","journal-title":"J Surg Oncol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"6664","DOI":"10.3390\/jcm14186664","article-title":"Nutritional status assessment using the patient-generated subjective global assessment (PG-SGA) in individuals with colorectal Cancer undergoing chemotherapy regimens","volume":"14","author":"S\u00e1nchez-Diestro","year":"2025","journal-title":"J Clin Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"100485","DOI":"10.1016\/j.advnut.2025.100485","article-title":"Nutrition interventions in the treatment of gastrointestinal symptoms during Cancer therapy: a systematic review and Meta-analysis","volume":"16","author":"Alzoubi","year":"2025","journal-title":"Adv Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e67108","DOI":"10.2196\/67108","article-title":"Digital health intervention to reduce malnutrition among individuals with gastrointestinal cancer receiving cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: feasibility, acceptability, and usability trial","volume":"11","author":"Lin","year":"2025","journal-title":"JMIR Cancer"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1007\/s40487-025-00358-y","article-title":"Nutrition in oncology: overcoming challenges to optimize the patient journey from prehabilitation to rehabilitation","volume":"13","author":"Klek","year":"2025","journal-title":"Oncol Ther"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"155","DOI":"10.15406\/ppij.2023.11.00414","article-title":"An overview of weight loss and GI associated toxicities among cancer patients","volume":"11","author":"Bangash","year":"2023","journal-title":"Pharm Pharmacol Int J"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1186\/s12876-025-04374-0","article-title":"Impact of PG-SGA-assessed malnutrition stratification on clinical outcomes in advanced gastrointestinal malignancies: a retrospective cohort study","volume":"25","author":"Zhuang","year":"2025","journal-title":"BMC Gastroenterol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"3917","DOI":"10.3390\/nu17243917","article-title":"Nutritional support for gastrointestinal Cancer patients: new (and old) Frontiers in management, a narrative review","volume":"17","author":"Khajoueinejad","year":"2025","journal-title":"Nutrients"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"12033","DOI":"10.1200\/JCO.2023.41.16_suppl.12033","article-title":"Risk of malnutrition and predisposing factors among Mexican patients with advanced cancer","volume":"41","author":"Contreras","year":"2023","journal-title":"J Clin Oncol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"9126","DOI":"10.1200\/jco.2007.25.18_suppl.9126","article-title":"Relationship between performance status and malnutrition in non-selected cancer patients: a nation-wide one-day survey","volume":"25","author":"Mateus","year":"2007","journal-title":"J Clin Oncol"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1780440\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T04:35:52Z","timestamp":1781152552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1780440\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,11]]},"references-count":36,"alternative-id":["10.3389\/fnut.2026.1780440"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1780440","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,11]]},"article-number":"1780440"}}