Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Cancer. 2010 Feb 1;116(3):695-704. doi: 10.1002/cncr.24808.
The study was undertaken to evaluate cardiorespiratory fitness, skeletal muscle function, and body composition of patients with newly diagnosed and untreated, postsurgical primary malignant glioma.
By using a cross-sectional design, patients with clinically stable (10 +/- 7 days postsurgery) high-grade glioma (HGG; n = 25) or low-grade glioma (LGG; n = 10) were studied. Participants performed a cardiopulmonary exercise test (CPET) with expired gas analysis to assess cardiorespiratory fitness (peak oxygen consumption, VO2peak). Other physiological outcomes included skeletal muscle cross-sectional area (CSA; magnetic resonance imaging), isokinetic muscle strength (isokinetic dynamometer), and body composition (air displacement plethysmography). Quality of life was assessed with the Functional Assessment of Cancer Therapy-Brain scale.
CPET was a feasible and safe procedure to assess VO2peak, with no serious adverse events. VO2peak indexed to total body weight and lean body mass (LBM) for both groups was 13.0 mL x weight x min(-1) and 19 mL x LBM x min(-1), the equivalent to 59% and 38% below age- and sex-predicted normative values, respectively. Skeletal muscle strength and mid-thigh CSA were lower in HGG relative to LGG patients (83 vs 125 Nm, P = .025; 94 vs 119 cm2, P = .171, respectively). Skeletal muscle isokinetic strength, CSA, and body composition outcomes predicted VO2peak (r = -0.59 to 0.68, P < .05).
Postsurgical glioma patients have markedly reduced cardiorespiratory fitness, isokinetic strength, and CSA. Prospective studies are now required to determine whether such abnormalities influence treatment toxicity and clinical outcome as well as to test the effect of appropriately selected interventions to prevent and/or mitigate dysfunction.
本研究旨在评估新诊断和未经治疗的术后原发性恶性脑胶质瘤患者的心肺功能、骨骼肌功能和身体成分。
采用横断面设计，对临床稳定（术后 10±7 天）的高级别胶质瘤（HGG；n=25）或低级别胶质瘤（LGG；n=10）患者进行研究。参与者进行心肺运动试验（CPET），并进行呼气末气体分析以评估心肺功能（峰值耗氧量，VO2peak）。其他生理结果包括骨骼肌横截面积（CSA；磁共振成像）、等速肌力（等速测力计）和身体成分（空气置换体积描记法）。采用癌症治疗-脑功能量表评估生活质量。
CPET 是一种可行且安全的评估 VO2peak 的方法，无严重不良事件。两组的 VO2peak 与体重和去脂体重（LBM）的指标分别为 13.0 mL x 体重 x min(-1)和 19 mL x LBM x min(-1)，分别相当于年龄和性别预测正常值的 59%和 38%。与 LGG 患者相比，HGG 患者的骨骼肌力量和大腿中段 CSA 较低（83 与 125 Nm，P=0.025；94 与 119 cm2，P=0.171）。骨骼肌等速力量、CSA 和身体成分结果预测 VO2peak（r=-0.59 至 0.68，P<.05）。
术后脑胶质瘤患者的心肺功能、等速力量和 CSA 明显降低。目前需要进行前瞻性研究，以确定这些异常是否会影响治疗毒性和临床结局，以及测试适当选择干预措施以预防和/或减轻功能障碍的效果。
