Characterization of Anthropometric Changes that Occur During Neoadjuvant Therapy for Potentially Resectable Pancreatic Cancer
Characterization of Anthropometric Changes that Occur During Neoadjuvant Therapy for Potentially Resectable Pancreatic Cancer
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DOI：
10.1245/s10434-014-4285-2
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发表时间：
2015-07-01
影响因子：
3.7
通讯作者：
Katz, Matthew H. G.
中科院分区：
文献类型：
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作者：
Cooper, Amanda B.;Slack, Rebecca;Katz, Matthew H. G.
对胰腺癌新辅助治疗期间可能发生的身体成分变化知之甚少。本研究旨在描述这些变化及其与治疗结局的潜在关系，研究人群包括接受新辅助化疗和放化疗的II期试验的可能可切除的胰腺癌患者。使用SliceOMatic软件（TomoVision，2012）和方案规定的CT扫描，在新辅助治疗给药前后测量骨骼肌和脂肪组织区室。在89名符合条件的患者中，46名（52%）患者在开始新辅助治疗前符合肌肉减少症的人体测量标准。在新辅助治疗期间，骨骼肌、内脏脂肪组织和皮下脂肪组织进一步耗竭，但这些损失并不妨碍潜在治愈性手术的实施。骨骼肌损失程度与无病生存期相关，而内脏脂肪损失与总体和无进展生存期相关。然而，完成所有的治疗，包括胰腺切除术，是唯一的独立显著的预测结果在多变量分析的总survival.These数据表明，标准的CT图像的身体成分分析可能提供临床相关的信息与潜在的可切除的胰腺癌患者接受新辅助治疗。在术前治疗方案的设计中必须考虑人体测量学的变化，进一步的努力应该集中在术前肌肉和内脏脂肪组织的维持上。
Little is known about changes in body composition that may occur during neoadjuvant therapy for pancreatic cancer. This study was designed to characterize these changes and their potential relationships with therapeutic outcomes.The study population consisted of patients with potentially resectable pancreatic cancer treated on a phase II trial of neoadjuvant chemotherapy and chemoradiation. Skeletal muscle and adipose tissue compartments were measured before and after administration of neoadjuvant therapy using SliceOMatic software (TomoVision, 2012) and protocol-mandated CT scans. Sarcopenia was defined using gender-adjusted norms.Among 89 eligible patients, 46 (52 %) patients met anthropometric criteria for sarcopenia prior to the initiation of neoadjuvant therapy. Further depletion of skeletal muscle, visceral adipose tissue, and subcutaneous adipose tissue occurred during neoadjuvant therapy, but these losses did not preclude the performance of potentially curative surgery. Degree of skeletal muscle loss correlated with disease-free survival while visceral adipose loss was associated with overall and progression-free survival. However, completion of all therapy, including pancreatectomy, was the only independently significant predictor of outcome in a multivariate analysis of overall survival.These data suggest that body composition analysis of standard CT images may provide clinically relevant information for patients with potentially resectable pancreatic cancer who receive neoadjuvant therapy. Anthropometric changes must be considered in the design of preoperative therapy regimens, and further efforts should focus on maintenance of muscle and visceral adipose tissue in the preoperative setting.