Association of Nutrition Parameters Including Bioelectrical Impedance and Systemic Inflammatory Response With Quality of Life and Prognosis in Patients With Advanced Non-Small-Cell Lung Cancer: A Prospective Study
Association of Nutrition Parameters Including Bioelectrical Impedance and Systemic Inflammatory Response With Quality of Life and Prognosis in Patients With Advanced Non-Small-Cell Lung Cancer: A Prospective Study
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DOI：
10.1080/01635581.2012.668744
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发表时间：
2012-01-01
影响因子：
2.9
通讯作者：
Arrieta, Oscar
中科院分区：
文献类型：
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作者：
Sanchez-Lara, Karla;Turcott, Jenny G.;Arrieta, Oscar
早期发现和治疗营养不良可以改善非小细胞肺癌(NSCLC)患者的生活质量和生存率。作为确定营养状态的一部分，需要非侵入性技术来评估身体成分的变化。这项研究的目的是评估营养参数与晚期非小细胞肺癌患者健康相关生活质量(HRQL)和生存率的关系。接受化疗的晚期非小细胞肺癌患者表现良好，符合东部合作肿瘤学组织(ECOG)0-2标准，前瞻性纳入研究。评价炎症参数如C反应蛋白、血小板/淋巴细胞指数、中性粒细胞/淋巴细胞指数、血清白介素6、肿瘤坏死因子-α，以及营养变量，如体重指数和血清白蛋白水平。在开始顺铂化疗前进行包括相角在内的生物电阻抗分析。采用欧洲癌症研究与治疗组织生活质量问卷(QLQ)-C30和QLQ-LC13量表对患者的生活质量进行评估。采用Kaplan-Meier方法计算总生存期(OS)，用对数秩比风险模型和COX比例风险模型进行分析。共纳入119例患者。平均BMI为24.8+/-4.5 kg/m(2)，患者平均体重减轻8.4%，中位相角5.8度。通过主观全球评估(SGA)、体重下降10%、BMI>；20来衡量营养不良与较低的HRQL评分相关。经多因素分析，血清IL-6含量高、位相角低、营养不良指标低的ECOG2患者仅有ECOG2[危险比(HR)2.795%可信区间(95%CI)1.5~4.7P=0.001]、
Early identification and treatment of nutritional deficiencies can lead to improved outcomes in the quality of life (QoL) and survival of patients with nonsmall cell lung cancer (NSCLC). Noninvasive techniques are needed to evaluate changes in body composition as part of determining nutritional status. The aim of the study was to evaluate the association of nutritional parameters in health-related quality of life (HRQL) and survival in patients with advanced NSCLC. Chemotherapy-naive patients with advanced NSCLC with good performance status Eastern Cooperative Oncology Group (ECOG) 0-2 were included prospectively in the study. We evaluated inflammatory parameters such as C-reactive protein, platelet/lymphocyte index, neutrophil/lymphocyte index, serum interleukin (IL)-6, and tumor necrosis factor-alpha, and nutritional variables such as body mass index (BMI) and serum albumin levels. Bioelectrical impedance analysis including phase angle was obtained before cisplatin-based chemotherapy was started. HRQL was assessed by application of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ)-C30 and QLQ-LC13 instruments at baseline. Overall survival (OS) was calculated with the Kaplan-Meier method and analyzed with log-rank and Cox proportional hazard models. One hundred nineteen patients were included. Mean BMI was 24.8 +/- 4.5 kg/m(2), average weight loss of patients was 8.4%, and median phase angle was 5.8 degrees. Malnutrition measured by subjective global assessment (SGA), weight loss >10%, BMI > 20 was associated with lower HRQL scales. Patients with ECOG2, high content serum IL-6, lower phase angle, and malnutrition parameters showed lower OS; however, after multivariate analysis, only ECOG 2 [ Hazard ratio (HR), 2.7; 95% confidence interval (95% CI), 1.5-4.7; P = 0.001], phase angle