Clinical impact of cachexia in unresectable locally advanced head and neck cancer: supplementary analysis of a phase II trial (JCOG0706-S2)
Clinical impact of cachexia in unresectable locally advanced head and neck cancer: supplementary analysis of a phase II trial (JCOG0706-S2)
复制标题
DOI：
10.1093/jjco/hyy145
复制
发表时间：
2019-01-01
影响因子：
2.4
通讯作者：
Eba, Junko
中科院分区：
文献类型：
--
作者：
Matsuzuka, Takashi;Kiyota, Naomi;Eba, Junko
目的：在JCOG 0706的II期临床试验中，评价恶病质（根据白蛋白和C反应蛋白水平的组合定义）对接受放化疗的不可切除的局部晚期头颈部鳞状细胞癌患者的临床影响。方法：45例患者接受放疗，共70戈伊/35 fr，同时接受S-1和顺铂。本分析在44例有可用数据的患者中进行。研究了治疗效果与恶病质之间的相关性。治疗前恶病质定义为血清白蛋白水平低于3.5 mg/dl，C反应蛋白水平高于0.5 mg/dl。与恶病质和非恶病质患者相比，（20% vs 72%），3年时至治疗失败的时间，（20% vs 53%）和完成治疗的比例（20%对79%）在恶病质患者中统计学上更差，而总生存率，恶病质患者的3年无进展生存率和局部无进展生存率更差。这项前瞻性研究的补充分析表明，癌症恶病质的治疗前状态是治疗结果的预后因素，局部晚期头颈部鳞状细胞癌患者接受放化疗治疗的依从性，以及该人群未来前瞻性试验中的候选分层因素。
Objectives: To evaluate the clinical impact of cachexia, defined by the combination of albumin and C-reactive protein levels, in patients with unresectable locally advanced head and neck squamous cell carcinomas who received chemoradiotherapy in a phase II trial of JCOG0706.Methods: Forty-five patients received radiation for a total of 70 Gy/35fr concurrently with S-1 and cisplatin. The present analysis was conducted in 44 patients with available data. The association between treatment efficacy and cachexia was investigated. Pretreatment cachexia was defined as a serum albumin level of less than 3.5 mg/dl and C-reactive protein level of more than 0.5 mg/dl.Results: Among the 44 patients, 5 patients had cachexia. On comparison with the cachexic and non-cachexic patients, the percentage of clinical complete remission (20% vs 72%), time to treatment failure at 3 years, (20% vs 53%) and proportion of treatment completion (20% vs 79%) were statistically worse in the cachexic patients, while overall survival, progression-free survival and local progression-free survival at 3 years tended to be worse in cachexic patients.Conclusions: This supplementary analysis from a prospective study suggests that a pretreatment status of cancer cachexia is a prognostic factor for treatment outcomes and compliance in patients with locally advanced head and neck squamous cell carcinomas treated with chemoradiotherapy, and a candidate stratification factor in future prospective trials in this population.