Impact of psoas muscle index assessed by a simple measurement method on tolerability and duration of continued treatment with sorafenib in hepatocellular carcinoma patients
Impact of psoas muscle index assessed by a simple measurement method on tolerability and duration of continued treatment with sorafenib in hepatocellular carcinoma patients
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DOI：
10.1097/meg.0000000000002346
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发表时间：
2022-07-01
影响因子：
2.1
通讯作者：
Maeda, Shin
中科院分区：
文献类型：
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作者：
Ogushi, Katsuaki;Chuma, Makoto;Maeda, Shin
在这项研究中，我们调查了腰大肌指数（PMI）的简单测量对索拉非尼治疗的耐受性的影响，从索拉非尼转换为瑞格非尼。方法回顾性分析109例Child-Pugh A级肝癌患者接受索拉非尼治疗的临床资料。通过测量并乘以L3椎体水平轴向计算机断层扫描图像上腰大肌的最大前/后和横向直径，并将双侧腰大肌面积之和标准化为身高（m）的平方，计算治疗前PMI。然后，我们统计分析了PMI与治疗不良事件（AE）、索拉非尼耐受性、治疗失败时间（TTF）和根据PMI分层的患者预后之间的关系。结果根据受试者工作特征曲线分析确定的PMI临界值（男性：7.04 cm（2）/m2;女性：4.40 cm（2）/m2）将患者分为高PMI组（n = 41）和低PMI组（n = 68），以确定索拉非尼的耐受性。低PMI组（50.0%）所有类型重度AE的频率均高于高PMI组（29.3%; P = 0.045）。高PMI组（51.2%）对索拉非尼的耐受性高于低PMI组（25.0%; P = 0.007）。此外，在多变量分析中，PMI与索拉非尼耐受性相关（优势比0.26; P = 0.008），是影响TTF的预后因素（风险比1.77; P = 0.021）。结论PMI可作为肝癌患者索拉非尼治疗耐受性及TTF的预测指标。
Background In this study, we investigated the impact of simple measurement of psoas muscle index (PMI) on the tolerability of sorafenib treatment of switch from sorafenib to regorafenib. Method This retrospective study enrolled 109 patients with Child-Pugh A hepatocellular carcinoma (HCC) treated with sorafenib. Pretreatment PMI was calculated by measuring and multiplying the greatest anterior/posterior and transverse diameters of the psoas muscles on axial computed tomography images at the L3 vertebral level, and normalizing the sum of bilateral psoas muscle areas by the square of the height in meters. We, then, statistically analyzed the association between PMI and adverse events (AEs) to treatment, tolerability of sorafenib, time to treatment failure (TTF), and prognosis in patients stratified according to PMI. Result Patients were divided into high PMI (n = 41) and low PMI (n = 68) groups based on the cutoff PMI values (men: 7.04 cm(2)/m(2); women: 4.40 cm(2)/m(2)) determined by receiver operating characteristic curve analysis to determine sorafenib tolerability. Frequencies of all types of severe AEs were higher in the low PMI group (50.0%) than in the high PMI group (29.3%; P = 0.045). The high PMI group (51.2%) had greater tolerance to sorafenib than the low PMI group (25.0%; P = 0.007). Moreover, in multivariable analysis, PMI was associated with sorafenib tolerability (odds ratio 0.26; P = 0.008) and was a prognostic factor affecting TTF (hazard ratio 1.77; P = 0.021). Conclusion PMI might be a predictive marker of tolerance to treatment and TTF in HCC patients receiving sorafenib treatment.