Weight loss over time and survival: a landmark analysis of 1000+ prospectively treated and monitored lung cancer patients.
Weight loss over time and survival: a landmark analysis of 1000+ prospectively treated and monitored lung cancer patients.
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DOI：
10.1002/jcsm.12625
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Jatoi A
中科院分区：
文献类型：
--
作者：
Le-Rademacher J;Lopez C;Wolfe E;Foster NR;Mandrekar SJ;Wang X;Kumar R;Adjei A;Jatoi A
癌症恶病质试验的合格标准和终点以及体重减轻是否应该包括在内仍然存在争议。虽然大多数恶病质试验在最初的癌症诊断后招募患者，但很少有研究涉及癌症诊断后体重减轻是否具有预后意义。我们汇总了来自肿瘤临床试验联盟（1998-2008）（一个国家资助的基础设施）前瞻性试验的非小细胞肺癌患者的数据。我们检查了（i）体重数据的可用性和体重变化以及（ii）生存率。共检查了822名患者。其中，659例（80%）在第2周期化疗开始时接受治疗; 656例（80%）的体重可用。到周期3和4时，分别有448例（55%）和384例（47%）的体重可用。从基线到第2周期之前，208例（32%）体重增加; 225例（34%）体重减轻<2%基线体重; 223例（656例中的34%）体重减轻2%或更多。体重增加、体重减轻<2%和体重减轻2%或以上的患者从第2周期开始的中位生存期分别为13.0、10.9和6.9个月。在多变量分析中，校正了年龄、性别、体能评分、治疗类型和体重指数，与体重增加相比，体重减轻2%或更多与总生存率差相关[风险比（HR）= 1.66; 95%置信区间（CI）：1.33-2.07; P < 0.001]，与体重减轻<2%相比，（HR = 1.57; 95%CI：1.27-1.95; P < 0.001）。虽然体重减轻<2%与体重增加相比总体生存率较差无关，但与无进展生存率较差相关（HR = 1.24; 95% CI：1.01-1.51; P = 0.036）。在一个单独的255例患者确认队列中观察到类似结果。体重应纳入癌症恶病质试验，因为它易于频繁测量和持续的预后关联。
Eligibility criteria and endpoints for cancer cachexia trials—and whether weight loss should be included—remain controversial. Although most cachexia trials enrol patients after initial cancer diagnosis, few studies have addressed whether weight loss well after a cancer diagnosis is prognostic. We pooled data from non‐small cell lung cancer patients from prospectively conducted trials within the Alliance for Clinical Trials in Oncology (1998–2008), a nationally funded infrastructure. We examined (i) weight data availability and weight changes and (ii) survival. A total of 822 patients were examined. Of these, 659 (80%) were on treatment at the beginning of Cycle 2 of chemotherapy; weight was available for 656 (80%). By Cycles 3 and 4, weight was available for 448 (55%) and 384 (47%), respectively. From baseline to immediately prior to Cycle 2, 208 (32%) gained weight; 225 (34%) lost <2% of baseline weight; and 223 (34% of 656) lost 2% or more. Median survival from the beginning of Cycle 2 was 13.0, 10.9, and 6.9 months for patients with weight gain, weight loss of <2%, and weight loss of 2% or more, respectively. In multivariate analyses, adjusted for age, sex, performance score, type of treatment, and body mass index, weight loss of 2% or more was associated with poor overall survival compared with weight gain [hazard ratio (HR) = 1.66; 95% confidence interval (CI): 1.33–2.07; P < 0.001] and compared with weight loss of <2% (HR = 1.57; 95% CI: 1.27–1.95; P < 0.001). Although weight loss of <2% was not associated with poorer overall survival compared with weight gain, it was associated with poorer progression‐free survival (HR = 1.24; 95% CI: 1.01–1.51; P = 0.036). Similar findings were observed in a separate 255‐patient validation cohort. Weight should be integrated into cancer cachexia trials because of its ease of frequent measurement and sustained prognostic association.
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影响因子：
2.9
作者：
Wiskemann, Joachim;Clauss, Dorothea;Steindorf, Karen
通讯作者：
Steindorf, Karen
影响因子：
6.2
作者：
Katakami N;Uchino J;Yokoyama T;Naito T;Kondo M;Yamada K;Kitajima H;Yoshimori K;Sato K;Saito H;Aoe K;Tsuji T;Takiguchi Y;Takayama K;Komura N;Takiguchi T;Eguchi K
通讯作者：
Eguchi K
癌症恶病质干预试验的监管指南请求。
DOI：
10.1002/jcsm.12083
发表时间：
2015-12
期刊：
Journal of cachexia, sarcopenia and muscle
影响因子：
--
作者：
Fearon K;Argiles JM;Baracos VE;Bernabei R;Coats A;Crawford J;Deutz NE;Doehner W;Evans WJ;Ferrucci L;Garcia JM;Gralla RJ;Jatoi A;Kalantar-Zadeh K;Lainscak M;Morley JE;Muscaritoli M;Polkey MI;Rosano G;Rossi-Fanelli F;Schols AM;Strasser F;Vellas B;von Haehling S;Anker SD
通讯作者：
Anker SD
DOI：
10.1177/0148607114550189
发表时间：
2014-11
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
Prado CM;Heymsfield SB
通讯作者：
Heymsfield SB
影响因子：
45.3
作者：
Edelman, Martin J.;Wang, Xiaofei;Vokes, Everett E.
通讯作者：
Vokes, Everett E.