Skeletal muscle and adipose tissue changes in the first phase of treatment of pediatric solid tumors.
Skeletal muscle and adipose tissue changes in the first phase of treatment of pediatric solid tumors.
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DOI：
10.1002/cam4.3584
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发表时间：
2021-01
期刊：
影响因子：
4
通讯作者：
Ladas EJ
中科院分区：
文献类型：
--
作者：
Joffe L;Shen W;Shadid G;Jin Z;Ladas EJ
人们越来越认识到身体成分是癌症结果的重要因素。在癌症护理中使用计算机断层扫描 (CT) 提供了根据第三腰椎图像准确量化全身瘦肉和脂肪组织的机会。我们试图证实使用常规拍摄的胸部单层胸部 CT 图像来评估儿科实体瘤患者的骨骼肌、残余瘦组织和肥胖情况。我们对在哥伦比亚大学欧文医学中心接受实体瘤治疗的儿童进行了回顾性分析。在诊断时和首次随访时进行疾病评估（6-14 周）分析骨骼肌 (SM)、残余瘦组织 (RLT) 和脂肪组织横截面积 (cm2)。使用 slice-O-matic 图像分析软件进行成像分析。在确定的 57 名患者中，39 名患者进行了包括椎间 T12-L1 的胸部 CT 成像，22 名患者还进行了 L3 的同步成像。 T12-L1 和 L3 的身体成分变量之间的相关系数很强 (r = 0.93–0.98)。配对 t 检验显示 SM（−4.2 ± 8.12，p = 0.003）和 RLT（−10.7 ± 28.5，p = 0.025）显着下降，并且内脏脂肪组织有显着增加的趋势（3.10 ± 9.65，p = 0.052）。单变量分析表明，年龄增长与 SM 损失增加之间存在显着相关性（β=−0.496，SE=0.194，p=0.011），而体重指数与身体成分变化之间缺乏关联。我们提供了第一线证据，证明来自常规胸部 CT 扫描的单层图像为评估儿科实体瘤患者的身体成分提供了一种简单、易于使用的机制。观察到不良的身体成分变化，特别是在青少年和年轻人中。概要：通过常规 CT 图像可以检测接受实体瘤治疗的儿科患者的身体成分变化。身体成分是一个日益受到关注的领域。几项针对成人癌症患者的研究发现，身体成分不佳（脂肪增加、肌肉减少）与治疗效果、生活质量和死亡密切相关。然而，由于缺乏现成的、敏感的指标，其在临床实践，特别是儿科的使用受到限制。我们试图证实使用常规收集的 CT 图像来测量身体成分。我们的结果证实了 CT 图像用于评估身体成分的用途，从而为儿科癌症护理创造了新的临床和研究机会。
Body composition is increasingly recognized as an important factor in cancer outcomes. Use of computed tomography (CT) in cancer care provides the opportunity to accurately quantify whole‐body lean and adipose tissues from images at the third lumbar spine. We sought to substantiate the use of routinely captured, single‐slice chest CT images at the thoracic level for evaluation of skeletal muscle, residual lean tissue, and adiposity among pediatric solid tumor patients. We performed a retrospective analysis among children who underwent treatment for a solid tumor at Columbia University Irving Medical Center. Skeletal muscle (SM), residual lean tissue (RLT), and adipose tissue cross‐sectional areas (cm2) were analyzed at diagnosis and at first follow‐up for disease evaluation (6–14 weeks). Imaging analysis was performed utilizing slice‐O‐matic image analysis software. Of the 57 patients identified, 39 had chest CT imaging that included intervertebral level T12‐L1, and 22 also had concurrent imaging at L3. Correlation coefficients between body composition variables at T12‐L1 and L3 were strong (r = 0.93–0.98). Paired t‐test showed a significant decrease in SM (−4.2 ± 8.12, p = 0.003) and RLT (−10.7 ± 28.5, p = 0.025) as well as a trend toward a significant increase in visceral adipose tissue (3.10 ± 9.65, p = 0.052). Univariable analysis demonstrated a significant association between increasing age and increased SM loss (β = −0.496 with SE = 0.194, p = 0.011), and a lack of association between body mass index and body composition changes. We provide the first line of evidence that single‐slice images from routinely obtained chest CT scans provide a simple, readily available mechanism for assessing body composition in pediatric solid tumor patients. Adverse body composition changes were observed, particularly among adolescents and young adults. Precis: Changes in body composition can be detected via routine CT images in pediatric patients undergoing treatment for solid tumors. Body composition is a growing area of interest. Several studies in adults with cancer have found that suboptimal body composition (increased fat, decreased muscle) is strongly associated with the efficacy of treatment, quality of life, and death. However, its use in clinical practice, especially pediatrics, is limited due to the lack of a readily available, sensitive indicator. We sought to substantiate the use of routinely collected CT images to measure body composition. Our results substantiate the use of CT images for the evaluation of body composition thereby creating new clinical and research opportunities in pediatric cancer care.
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影响因子：
2.6
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