Association of phase angle with muscle function and prognosis in patients with head and neck cancer undergoing chemoradiotherapy
Association of phase angle with muscle function and prognosis in patients with head and neck cancer undergoing chemoradiotherapy
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头颈癌放化疗患者相位角与肌肉功能及预后的关系
DOI：
10.1016/j.nut.2022.111798
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发表时间：
2022
期刊：
影响因子：
4.4
通讯作者：
Hamada Yasuhiro
中科院分区：
文献类型：
--
作者：
Yamanaka Ayaka;Yasui-Yamada Sonoko;Furumoto Taiki;Kubo Miyu;Hayashi Haruka;Kitao Midori;Wada Kyoko;Ohmae Nao;Kamimura Seiichiro;Shimada Aki;Sato Nori;Katoh Shinsuke;Takeda Noriaki;Hamada Yasuhiro
目的本研究的目的是探讨相位角（PhA）与其他参数（如肌肉质量/质量/力量和身体功能）的相关性，评估放化疗前（CRT） PhA的预后相关性，并提出PhA在亚洲头颈癌（HNC）患者中的参考值。方法96例接受CRT治疗的HNC患者按PhA 25百分位值按性别分为维持PhA组和低PhA组。预处理PhA采用直接节段多频生物电阻抗分析测量，肌肉质量采用超声图像回波强度评估。研究了PhA与其他参数的相关性，并评估了不良事件、治疗中断和3年生存率方面的组间差异。结果spha与等长膝关节伸直力（R= 0.710）、握力（R= 0.649）、骨骼肌质量指数（R= 0.620）、最大步速（R= 0.543， P< 0.001）呈正相关。PhA与回声强度呈负相关（R= - 0.439），与5次坐立测试呈负相关（R= - 0.505， P< 0.01）。低pha组的严重贫血发生率（低pha组为52%，维持pha组为17%）、误吸（17%,1%）、放疗中断（17%,3%）和3-y生存率差（47%,81%）均高于维持pha组（P< 0.05）。结论pha与肌量/质量/力量及身体机能相关。低PhA与严重不良事件、治疗中断和较短的生存期相关。这些研究结果表明，男性4.6°和女性4°可作为亚洲HNC患者的预后参考值。
ObjectivesThe aims of this study were to investigate the correlation of phase angle (PhA) with other parameters (e.g., muscle mass/quality/strength and physical function), assess the prognostic relevance of prechemoradiotherapy (CRT) PhA, and suggest a reference value of PhA in Asian patients with head and neck cancer (HNC).MethodsNinety-six patients with HNC who underwent CRT were divided into two groups— maintained-PhA group and low-PhA group—according to the PhA 25th percentile values by sex. Pretreatment PhA was measured using direct segmental multifrequency bioelectrical impedance analysis, and muscle quality was assessed using echo intensity in ultrasound images. Correlation of PhA with other parameters was investigated, and between-group differences with respect to adverse events, treatment interruption, and 3-y survival were assessed.ResultsPhA showed a positive correlation with isometric knee extension force (R= 0.710), handgrip strength (R= 0.649), skeletal muscle mass index (R= 0.620), and maximum gait speed (R= 0.543;P< 0.001). PhA showed a negative correlation with echo intensity (R= −0.439) and five times sit-to-stand test (R= −0.505;P< 0.01). The low-PhA group had a higher incidence of severe anemia (52% in low-PhA versus 17% in maintained-PhA), aspiration (17 versus 1%), radiotherapy interruption (17 versus 3%), and poor 3-y survival (47 versus 81%) than the maintained-PhA group (P< 0.05).ConclusionPhA was correlated with muscle mass/quality/strength, and physical function. Low PhA was associated with severe adverse events, treatment interruption, and shorter survival. These findings suggested that 4.6° for men and 4° for women may be useful as prognostic reference values in Asian patients with HNC.