Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients-Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study.
Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients-Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study.
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DOI：
10.1007/s00520-016-3156-8
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发表时间：
2016-08
期刊：
影响因子：
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通讯作者：
Watanabe K
中科院分区：
文献类型：
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作者：
Takayama K;Atagi S;Imamura F;Tanaka H;Minato K;Harada T;Katakami N;Yokoyama T;Yoshimori K;Takiguchi Y;Hataji O;Takeda Y;Aoe K;Kim YH;Yokota S;Tabeta H;Tomii K;Ohashi Y;Eguchi K;Watanabe K
尽管癌症恶病质的主要特征是持续的体重减轻（BW），通常是对恶性肿瘤的反应，但恶病质的病理生理学仍未得到解决。为了阐明BW损失与其他相关临床因素之间的关系，我们在晚期非小细胞肺癌（NSCLC）患者中进行了一项全国性、多机构、前瞻性、观察性研究。美国东部肿瘤协作组体能状态（PS）评分为0-2的初治IV期NSCLC患者有资格入选。在基线和1年内每4周评估一次体重、握力（HGS）、生活质量（QOL）、Karnofsky行为量表（KPS）、生化参数和生存率。用线性回归分析法分析体重损失与其他因素的关系。通过Kaplan-Meier方法绘制估计的生存曲线，并通过对数秩检验进行应用。通过主成分分析确定与癌症恶病质相关的临床因素。采用广义估计方程法分析恶病质进展对生存质量的影响。共分析了406例患者。体重下降与QOL、HGS、KPS和生化参数的恶化显著相关。在整个研究期间观察BW损失的发生率。随着体重下降的进展，患者的总生存期明显缩短。体重下降、HGS下降、厌食和疲劳被确定为恶病质的核心因素，导致生活质量恶化。体重下降最可能恶化晚期NSCLC患者的生活质量并缩短生存期，应密切监测。本文的在线版本（doi：10.1007/s 00520 -016-3156-8）包含补充材料，可供授权用户使用。
Although cancer cachexia is mainly characterized by persistent loss of body weight (BW), usually in response to a malignancy, the pathophysiology of cachexia remains unresolved. To elucidate the relationship between the loss of BW and other related clinical factors, we conducted a nationwide, multi-institutional, prospective, observational study in patients with advanced non-small cell lung cancer (NSCLC). Treatment-naïve stage IV NSCLC patients with an Eastern Cooperative Oncology Group performance status (PS) of 0–2 were eligible. BW, handgrip strength (HGS), quality of life (QOL), Karnofsky Performance Scale (KPS), biochemical parameters, and survival were evaluated at baseline and every 4 weeks for 1 year. The relationship between BW loss and other factors was examined by linear regression analysis. Estimated survival curves were drawn by the Kaplan-Meier method and applied by the log-rank test. Clinical factors associated with cancer cachexia were identified through principal component analysis. The generalized estimating equation approach was used to analyze the deterioration of QOL resulting from the progression of cachexia. A total of 406 patients were analyzed. BW loss was significantly associated with worsening of QOL, HGS, KPS, and biochemical parameters. The incidence of BW loss was observed throughout the study period. Overall survival was significantly shorter in patients as BW loss progressed. BW loss, decrease in HGS, anorexia, and fatigue were identified as core factors of cachexia that contributed to the deterioration of QOL. BW loss most likely deteriorated QOL and shortened survival in patients with advanced NSCLC and should be closely monitored. The online version of this article (doi:10.1007/s00520-016-3156-8) contains supplementary material, which is available to authorized users.