What question did this study set out to answer?

To assess the predictive value of the modified Glasgow prognostic score in patients with non-small cell lung cancer receiving radiation therapy.

March 21, 2026Open Access

A prospective study on the predictive value of the modified Glasgow prognostic score in non-small cell lung cancer treated with radiation therapy

Key Points

To assess the predictive value of the modified Glasgow prognostic score in patients with non-small cell lung cancer receiving radiation therapy.
Prospective observational design with 82 adults diagnosed with NSCLC.
Assessment of mGPS based on serum C-reactive protein and albumin levels.
Categorization of patients by stage and treatment type, including stereotactic body radiotherapy and chemoradiotherapy.
Evaluation of 2-year overall survival, local control rate, and distant failure-free rate.
High mGPS is significantly associated with reduced overall survival (p = 0.001).
2-year overall survival, local control rate, and distant failure-free rate were 85.4%, 86.5%, and 80.1%, respectively.
In the subgroup treated with stereotactic body radiotherapy, high mGPS remained a strong predictor of inferior overall survival (p = 0.007).

Abstract

This prospective observational study aimed to evaluate the prognostic value of the modified Glasgow prognostic score (mGPS), an inflammation- and nutrition-based index, in patients with non-small cell lung cancer (NSCLC) undergoing radiotherapy (RT) delivered with definitive-dose intent. Adults (≥ 18 years) with histologically or clinically confirmed NSCLC and Eastern Cooperative Oncology Group performance status 0–1 were enrolled. Pretreatment mGPS, derived from serum C-reactive protein (CRP) and albumin levels, was categorized as low (0) or high (1–2). Patients with stage 0–I disease received stereotactic body radiotherapy (SBRT), whereas those with stage II or higher underwent concurrent chemoradiotherapy or definitive RT alone. The primary endpoint was 2-year overall survival (OS); secondary endpoints were 2-year local control rate (LCR) and distant failure-free rate (DFFR). Between January 2021 and March 2023, 82 patients were analyzed (median age, 78 years; 70% treated with SBRT). With a median follow-up of 30.2 months (IQR 23.1–36.3), 2-year OS, LCR, and DFFR were 85.4%, 86.5%, and 80.1%, respectively. High mGPS was significantly associated with inferior OS (hazard ratio HR 5.71; 95% CI 1.96–16.66; p = 0.001), but not with LCR or DFFR. In the SBRT subgroup (n = 57), high mGPS remained a strong predictor of inferior OS (HR 7.15; 95% CI 1.73–29.61; p = 0.007). On multivariable analysis, high mGPS persisted as an independent prognostic factor in both the overall and SBRT cohorts. To our knowledge, this is the first prospective study to evaluate mGPS in NSCLC patients treated with RT, including SBRT. High mGPS independently predicted inferior OS in Cox regression analyses, highlighting the prognostic significance of host-related systemic inflammation and nutritional status. These findings support incorporating mGPS into pretreatment evaluation as a simple, objective biomarker to facilitate risk-adapted management and multidisciplinary decision-making in clinical practice.

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