Department of Radiation Oncology, Apollo Specialty Hospitals, Chennai, India.
Department of Neurosurgery, Apollo Specialty Hospitals, Chennai, India.
Int J Radiat Oncol Biol Phys. 2018 Sep 1;102(1):204-209. doi: 10.1016/j.ijrobp.2018.05.024. Epub 2018 May 17.
Correlation of body mass index (BMI) with clinical outcome in patients with glioblastoma is not well documented. Hence, we studied the association between survival and pretreatment BMI in glioblastoma patients.
In this retrospective study, only patients with histopathology-confirmed glioblastoma were included. Their BMIs were calculated from height and weight measurements and recorded in medical records at their first examination. Treatment plans for all patients consisted of concurrent radiation therapy and temozolomide, followed by maintenance therapy with temozolomide. The primary endpoint was overall survival (OS). Univariate and multivariate Cox proportional hazards models were used to estimate the mortality risk associated with BMI as a continuous and categorical variable. A BMI of 18.5 to 24.9 kg/m was classified as normal, 25.0 to 29.9 kg/m as overweight, and ≥30.0 kg/m as obese.
Data from 392 patients treated from January 2008 through June 2016 were analyzed. At a median follow-up of 48.6 months, the median OS was 13.5 months in normal subjects, 15.4 months in overweight subjects, and 15.1 months in obese subjects. A total of 81% of the patients died. The hazard ratios for overweight and obese patients were 0.70 (95% confidence interval, 0.54-0.92; P = .009) and 0.66 (95% confidence interval, 0.45-0.98; P = .04), respectively, when adjusted for age, Karnofsky performance score, and extent of resection. Sex, diabetes, and hypertension had no significant interactions.
Patients with elevated BMIs had significantly better OS in our series of patients. The mechanism of this interaction needs to be explored further to understand this association.
体重指数（BMI）与胶质母细胞瘤患者临床结局的相关性尚未得到充分证实。因此，我们研究了胶质母细胞瘤患者生存与治疗前 BMI 之间的关系。
在这项回顾性研究中，仅纳入了经组织病理学证实的胶质母细胞瘤患者。他们的 BMI 是根据身高和体重测量值计算得出，并记录在首次检查的病历中。所有患者的治疗方案均包括同步放化疗和替莫唑胺，随后进行替莫唑胺维持治疗。主要终点是总生存期（OS）。使用单变量和多变量 Cox 比例风险模型来估计 BMI 作为连续和分类变量与死亡率风险的相关性。18.5 至 24.9 kg/m2 被归类为正常，25.0 至 29.9 kg/m2 为超重，≥30.0 kg/m2 为肥胖。
对 2008 年 1 月至 2016 年 6 月期间治疗的 392 名患者的数据进行了分析。在中位随访 48.6 个月时，正常组的中位 OS 为 13.5 个月，超重组为 15.4 个月，肥胖组为 15.1 个月。共有 81%的患者死亡。在校正年龄、卡诺夫斯基表现评分和切除范围后，超重和肥胖患者的风险比分别为 0.70（95%置信区间，0.54-0.92；P =.009）和 0.66（95%置信区间，0.45-0.98；P =.04）。性别、糖尿病和高血压没有显著的交互作用。
在我们的患者系列中，BMI 较高的患者的 OS 显著改善。需要进一步探讨这种相互作用的机制，以了解这种关联。
