Clinical impact of skeletal muscle area in patients with non-small cell lung cancer treated with anti-PD-1 inhibitors
Clinical impact of skeletal muscle area in patients with non-small cell lung cancer treated with anti-PD-1 inhibitors
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DOI：
10.1007/s00432-020-03146-5
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发表时间：
2020-02-05
影响因子：
3.6
通讯作者：
Mori, Masaki
中科院分区：
文献类型：
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作者：
Takada, Kazuki;Yoneshima, Yasuto;Mori, Masaki
目的本研究旨在阐明骨骼肌面积（SMA）在接受抗程序性细胞死亡-1（PD-1）抑制剂治疗的非小细胞肺癌（NSCLC）患者中的临床影响。方法对103例晚期或复发NSCLC患者应用PD-1抑制剂治疗的资料进行单因素和多因素分析。使用OsiriX软件（32位，版本5.8; OsiriX，日内瓦，瑞士）在计算机断层扫描图像上测量第三腰椎（L3）水平的SMA。L3肌肉指数（cm（2）/m（2））定义为L3水平的SMA（cm（2））除以身高（m）的平方。结果L3肌肉指数（低）是无进展生存期（P = 0.0399）和总生存期（P = 0.0155）的独立预测因子。此外，L3肌肉指数（低）组的疾病控制率（49.0% [25/51]）显著低于L3肌肉指数（高）组（73.1% [38/52]; P = 0.0117）。然而，L3肌肉指数（低）组（21.6% [11/51]）和L3肌肉指数（高）组（32.7% [17/52]; P = 0.2031）的缓解率之间无显著差异。结论L3肌肉指数（低）是接受抗PD-1抑制剂治疗的NSCLC患者预后不良的独立预测因子。
Purpose The aim of this study was to elucidate the clinical impact of skeletal muscle area (SMA) in patients with non-small cell lung cancer (NSCLC) treated with anti-programmed cell death-1 (PD-1) inhibitors. Methods Univariate and multivariate analyses were performed on data of 103 patients with advanced or recurrent NSCLC treated with anti-PD-1 inhibitors. The SMA was measured at the level of the third lumbar vertebral (L3) on computed tomography images using OsiriX software (32-bit, version 5.8; OsiriX, Geneva, Switzerland). The L3 muscle index (cm(2)/m(2)) was defined as the SMA (cm(2)) at the L3 level divided by the height (m) squared. Results L3 muscle index (Low) was an independent predictor of both progression-free (P = 0.0399) and overall survival (P = 0.0155). Moreover, the disease control rate was significantly lower in the L3 muscle index (Low) group (49.0% [25/51]) than in the L3 muscle index (High) group (73.1% [38/52]; P = 0.0117). However, there was no significant difference between the response rates of the L3 muscle index (Low) group (21.6% [11/51]) and L3 muscle index (High) group (32.7% [17/52]; P = 0.2031). Conclusions L3 muscle index (Low) is an independent predictor of worse outcomes in NSCLC patients treated with anti-PD-1 inhibitors.