Sarcopenia Is Linked to Treatment Toxicity in Patients With Metastatic Colorectal Cancer
Sarcopenia Is Linked to Treatment Toxicity in Patients With Metastatic Colorectal Cancer
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DOI：
10.1080/01635581.2014.894103
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发表时间：
2014-05-19
影响因子：
2.9
通讯作者：
Taieb, Julien
中科院分区：
文献类型：
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作者：
Barret, Maximilien;Antoun, Sami;Taieb, Julien
化疗毒性可能与骨骼肌减少（肌肉减少症）有关。我们评估了肌肉减少症对转移性结直肠癌（mCRC）患者化疗毒性的影响。本前瞻性、横断面、多中心研究纳入了3家医院的所有连续mCRC患者。生成了几个营养指数和评分。分析计算机断层扫描（CT）图像，以评价肌肉组织（MT）、内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的横截面积。在临床评价后2个月内评价毒性。51例mCRC患者入组研究。71%的患者（39%的女性和82%的男性）观察到肌肉减少症，而使用体重指数（BMI）或使用营养风险指数（NRI）分别仅4%和18%被认为是体重不足或严重营养不良。在28%的患者中观察到3-4级毒性。在包括年龄、性别、BMI、肌肉减少症、SAT和VAT的多变量分析中，与3-4级毒性相关的唯一因素是肌肉减少症（比值比= 13.55; 95%置信区间[1.08; 169.31]，P = 0.043）。在接受化疗的mCRC患者中，肌肉减少症比可见的营养不良更常见。尽管我们的研究中纳入的患者数量较少，但我们发现肌肉减少症与严重的化疗毒性显著相关。
Chemotherapy toxicity could be linked to decreased skeletal muscle (sarcopenia). We evaluated the effect of sarcopenia on chemotherapy toxicity among metastatic colorectal cancer (mCRC) patients. All consecutive mCRC patients in 3 hospitals were enrolled in this prospective, cross-sectional, multicenter study. Several nutritional indexes and scores were generated. Computed tomography (CT) images were analyzed to evaluate cross-sectional areas of muscle tissue (MT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Toxicities were evaluated in the 2 mo following clinical evaluation. Fifty-one mCRC patients were included in the study. Sarcopenia was observed in 71% of patients (39% of women and 82% of men) whereas only 4% and 18% were considered as underweight using body mass index (BMI) or severely malnourished using the Nutritional Risk Index (NRI), respectively. Grade 3-4 toxicities were observed in 28% of patients. In multivariate analysis including age, sex, BMI, sarcopenia, SAT, and VAT, the only factor associated with Grade 3-4 toxicities was sarcopenia (odds ratio = 13.55; 95% confidence interval [1.08; 169.31], P = 0.043). In mCRC patients undergoing chemotherapy, sarcopenia was much more frequently observed than visible malnutrition. Despite the small number of patients included in our study, we found sarcopenia to be significantly associated with severe chemotherapy toxicity.