Department of Investigational Cancer Therapeutics (A Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Nutr Cancer. 2012;64(2):206-17. doi: 10.1080/01635581.2012.638433. Epub 2012 Jan 9.
The association between body composition parameters and toxicity from hepatic arterial infusion (HAI) chemotherapy regimens has not been analyzed. We assessed data from patients with advanced cancer and liver metastases treated on a clinical trial of a regimen of HAI oxaliplatin combined with systemic 5-fluorouracil/leucovorin and bevacizumab. Correlations between patient characteristics, response, and toxicity and body composition data taken from CT images were analyzed. Forty-eight of 57 patients (mean age 56 yr; 60% women) had available CT scans. The most common diagnosis was colorectal cancer (22/48, 46%); 30/48 patients (63%) had body mass index (BMI) ≥25 kg/m(2). Twenty (42%) of 48 patients were sarcopenic. Grade 3-4 adverse events did not differ among patients with and without sarcopenia or according to BMI. The median survival (95% C]) was 167 (128-206) days for sarcopenic and 280 (214-346) days for nonsarcopenic patients (P = 0.271). Among patients treated at the maximum tolerated dose, the median survival was 103 days for sarcopenic and 312 days for nonsarcopenic patients (P = 0.173). Sarcopenia was present in 30% (6/20) of patients with reduction in tumor size posttreatment, and in 52% (14/27) of patients with increased tumor size (P = 0.171). In conclusion, body composition was not significantly associated with toxicities or survival in our small sample.
身体成分参数与肝动脉灌注(HAI)化疗方案毒性之间的关系尚未分析。我们评估了在一项 HAI 奥沙利铂联合全身 5-氟尿嘧啶/亚叶酸和贝伐单抗方案临床试验中治疗的晚期癌症和肝转移患者的数据。分析了患者特征、反应和毒性与从 CT 图像获得的身体成分数据之间的相关性。48/57 例患者(平均年龄 56 岁;60%为女性)有可用的 CT 扫描。最常见的诊断是结直肠癌(22/48,46%);30/48 例患者(63%)的体质指数(BMI)≥25 kg/m(2)。48 例患者中有 20 例(42%)为肌肉减少症。有或没有肌肉减少症的患者以及根据 BMI 分层的患者的 3-4 级不良事件无差异。肌肉减少症患者的中位生存时间(95%CI)为 167(128-206)天,非肌肉减少症患者为 280(214-346)天(P=0.271)。在接受最大耐受剂量治疗的患者中,肌肉减少症患者的中位生存时间为 103 天,非肌肉减少症患者为 312 天(P=0.173)。20 例(6/20)治疗后肿瘤体积缩小的患者中有 30%存在肌肉减少症,27 例(14/27)肿瘤体积增大的患者中有 52%存在肌肉减少症(P=0.171)。总之,在我们的小样本中,身体成分与毒性或生存无显著相关性。