Relationships among body mass index, longitudinal body composition alterations, and survival in patients with locally advanced pancreatic cancer receiving chemoradiation: a pilot study.
Relationships among body mass index, longitudinal body composition alterations, and survival in patients with locally advanced pancreatic cancer receiving chemoradiation: a pilot study.
复制标题
DOI：
10.1016/j.jpainsymman.2011.09.010
复制
发表时间：
2012-08
影响因子：
4.7
通讯作者：
Bruera, Eduardo
中科院分区：
文献类型：
--
作者：
Dalal, Shalini;Hui, David;Bidaut, Luc;Lem, Kristen;Del Fabbro, Egidio;Crane, Christopher;Reyes-Gibby, Cielito C.;Bedi, Deepak;Bruera, Eduardo
关键词：
在胰腺癌中，肥胖或体重减轻与较高的死亡率相关。目的：探讨胰腺癌患者体重指数(BMI)、纵向身体成分改变与临床预后的关系。本文回顾了41例不能手术的局部晚期胰腺癌患者，他们参与了一项前瞻性的放化疗研究。根据放射治疗前后(中位间隔104天)获得的两组计算机断层扫描图像分析身体成分。中位年龄59岁，56%的患者为女性。24名患者(59%)超重(22%)或肥胖(37%)。26例(63%)患者出现骨质疏松症。在随访时，33例(81%)患者体重减轻。治疗前后体重下降5%(P<；0.001)，骨骼肌下降4%(P=0.003)，内脏脂肪下降13%(P<；0.001)，皮下脂肪下降11%(P=0.002)。骨量丢失与年龄(P=0.001.0 3)、基线体重指数(P<；0.0 4)和增值税指数(P=0.0 4)呈正相关。肥胖患者在体重(P=0.009.0 5)、运动负荷(P=0.0 2)和增值税(P=0.0 2)方面的减少量较高。中位生存期为12个月。在单变量分析中，年龄、基线肥胖、骨质疏松性肥胖以及体重、SKM和VAT减少(%)与较差的存活率相关。在多因素分析中，只有年龄(危险比(HR)=1.033，P=0.0 4)和增值税损失(HR=2.6，P=0.0 3)仍有显著意义。我们的初步研究结果表明，肥胖患者的体重、SKM和VAT减少更多，这可能导致这些患者的存活率较低。
In pancreatic cancer, the presence of obesity or weight loss is associated with higher mortality. To explore the relationships among body mass index (BMI), longitudinal body composition alterations, and clinical outcomes in pancreatic cancer patients. Records of 41 patients with inoperable, locally advanced pancreatic cancer who participated in a prospective chemo-radiation study were reviewed. Body composition was analyzed from two sets of computed-tomography images obtained before and after radiation treatment (median interval 104 days). Median age was 59 years, and 56% of patients female. Twenty-four (59%) patients were either overweight (22%) or obese (37%). Sarcopenia was present in 26 (63%) patients. At follow-up, weight loss was experienced by 33 (81%) patients. The median losses (%) before and after treatment were: weight 5% (P< 0.001), skeletal muscle (SKM) 4% (P=0.003), visceral adipose tissue (VAT) 13% (P< 0.001), and subcutaneous adipose tissue (SCAT) 11% (P=0.002). SKM loss positively correlated with age (P=0.03), baseline BMI (P < 0.001), and VAT (P=0.04) index. Obese patients experienced higher losses in weight (P=0.009), SKM (P=0.02), and VAT (P=0.02). Median survival was 12 months. In univariate analysis, age, baseline obesity, sarcopenic obesity, and losses (%) in weight, SKM, and VAT were associated with worse survival. In multivariate analysis, only age (hazard ratio (HR)=1.033, P=0.04 and higher VAT loss (HR=2.6, P=0.03) remained significant. Our preliminary findings suggest that obese patients experience higher losses in weight, SKM and VAT, which may contribute to poorer survival in these patients.
登录
查看更多内容
影响因子：
120.7
作者：
Flegal, Katherine M.;Carroll, Margaret D.;Curtin, Lester R.
通讯作者：
Curtin, Lester R.
影响因子：
45.3
作者：
Crane, CH;Ellis, LM;Wolff, R
通讯作者：
Wolff, R
影响因子：
8.8
作者：
Bing, C.;Russell, S.;Becket, E.;Pope, M.;Tisdale, M. J.;Trayhurn, P.;Jenkins, J. R.
通讯作者：
Jenkins, J. R.
影响因子：
56.9
作者：
Das, Suman K.;Eder, Sandra;Hoefler, Gerald
通讯作者：
Hoefler, Gerald
影响因子：
7.7
作者：
Goodpaster, BH;Kelley, DE;Thaete, FL
通讯作者：
Thaete, FL