Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer
Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer
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DOI：
10.1007/s00520-014-2534-3
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发表时间：
2015-06-01
影响因子：
3.1
通讯作者：
Yamamoto, Nobuyuki
中科院分区：
文献类型：
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作者：
Kimura, Madoka;Naito, Tateaki;Yamamoto, Nobuyuki
恶性恶病质（CC）常见于晚期肺癌患者，与预后不良有关。然而，对化疗期间发生的CC知之甚少。我们评估了晚期非小细胞肺癌（NSCLC）患者化疗过程中出现的CC和骨骼肌萎缩对预后的影响。回顾性分析134例新诊断的非小细胞肺癌患者的临床资料。CC被定义为体重指数< 20 kg/m的患者体重减轻> %或> %(2)。在化疗开始后的基线（T1）、3个月（T2）、6个月（T3）和12个月（T4）评估CC。骨骼肌质量评估采用木材骨骼肌指数（LSMI）。T1、T2、T3、T4发生CC的患者比例分别为45.6%、46.1%、25.5%、26.0%。T2时，CC患者发生3级化疗性厌食症的频率高于无CC患者（15.4% vs. 0.0%, P = 0.0044）。在所有时间点，CC患者的生存时间均短于非CC患者。低LSMIs患者(男性，< 41 cm(2)/m(2)；< 38 cm(2)/m(2)的女性预后较差。T1、T2、T3和T4时CC的校正Cox比例风险比和相应的置信区间分别为2.53（1.33-4.88）、1.97（1.27-3.06）、3.86（2.14-6.81）和1.62（0.80-3.16）。在接受化疗的晚期非小细胞肺癌患者中，CC的存在和骨骼肌质量的减少与预后不良有关。
Cancer cachexia (CC) is commonly seen in advanced lung cancer patients and associated with poor prognosis. However, little is known about CC that develops during chemotherapy. We evaluated the prognostic impact of CC and skeletal muscle wasting that develops during the course of chemotherapy in advanced non-small cell lung cancer (NSCLC) patients.The clinical data of 134 newly diagnosed NSCLC patients were retrospectively reviewed. CC was defined as a body weight loss > 5 or > 2 % in patients with a body mass index of < 20 kg/m(2). CC was assessed at baseline (T1) and 3 months (T2), 6 months (T3), and 12 months (T4) after chemotherapy initiation. Skeletal muscle mass was assessed using the lumber skeletal muscle index (LSMI).The proportion of patients with CC at T1, T2, T3, and T4 was 45.6, 46.1, 25.5, and 26.0 %, respectively. The frequency of grade 3 chemotherapy-induced anorexia was higher in patients with CC than those without CC at T2 (15.4 vs. 0.0 %, P = 0.0044). At all time points, patients with CC had shorter survival times than those without CC. Patients with low LSMIs (men, < 41 cm(2)/m(2); women, < 38 cm(2)/m(2)) tended to have poor prognosis. Adjusted Cox proportional hazard ratios and corresponding confidence intervals for CC at T1, T2, T3, and T4 were 2.53 (1.33-4.88), 1.97 (1.27-3.06), 3.86 (2.14-6.81), and 1.62 (0.80-3.16), respectively.CC presence and decreased skeletal muscle mass are associated with poor prognosis in advanced NSCLC patients receiving chemotherapy.