Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada.
Clin Colorectal Cancer. 2019 Dec;18(4):e385-e393. doi: 10.1016/j.clcc.2019.07.005. Epub 2019 Jul 15.
We conducted this study to assess the effect of baseline body mass index (BMI) on the toxicity and efficacy of systemic chemotherapy among patients with metastatic colorectal cancer (CRC).
This was a pooled analysis of 5 clinical trials (NCT00115765, NCT00364013, NCT00272051, NCT00305188, and NCT00384176), which were accessed from the Project Data Sphere (www.projectdatasphere.org) platform. Multivariable logistic regression analysis was used to assess the relationship between BMI and the probability of different toxicities. Kaplan-Meier survival estimates were used to assess the effect of BMI on overall and progression-free survival. Multivariable Cox regression analysis was additionally conducted to evaluate the effect of BMI on overall and progression-free survival.
A total of 3155 patients were included in the current analysis. Within multivariable logistic regression analysis, higher BMI was associated with higher probability of all-grade nausea and vomiting (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.009-1.042; P = .002) and peripheral neuropathy (OR, 1.018; 95% CI, 1.001-1.034; P = .036; analysis restricted to oxaliplatin-treated patients). Lower BMI was associated with a higher probability of all-grade anemia (OR, 0.975; 95% CI, 0.956-0.995; P = .015), high-grade anemia (OR, 0.941; 95% CI, 0.890-0.994; P = .030), all-grade neutropenia (OR, 0.983; 95% CI, 0.968-0.999; P = .034), and high-grade neutropenia (OR, 0.962; 95% CI, 0.945-0.979; P < .001). Higher BMI also seemed to correlate with better overall survival in a multivariable Cox regression model (hazard ratio as a continuous variable: 0.977; 95% CI, 0.967-0.988; P < .001).
Lower BMI was associated with a higher risk of hematological toxicities (anemia and neutropenia) whereas higher BMI might be associated with a higher risk of nausea, vomiting, and peripheral neuropathy. Higher BMI also seemed to be associated with better overall survival among patients with metastatic CRC.
我们进行这项研究旨在评估基线体重指数（BMI）对转移性结直肠癌（CRC）患者全身化疗毒性和疗效的影响。
这是对 5 项临床试验（NCT00115765、NCT00364013、NCT00272051、NCT00305188 和 NCT00384176）的汇总分析，这些研究可从 Project Data Sphere（www.projectdatasphere.org）平台获取。多变量逻辑回归分析用于评估 BMI 与不同毒性发生概率之间的关系。Kaplan-Meier 生存估计用于评估 BMI 对总生存期和无进展生存期的影响。多变量 Cox 回归分析进一步评估了 BMI 对总生存期和无进展生存期的影响。
共有 3155 名患者纳入本分析。多变量逻辑回归分析显示，较高的 BMI 与所有级别恶心呕吐（优势比 [OR]，1.025；95%置信区间 [CI]，1.009-1.042；P =.002）和周围神经病变（OR，1.018；95%CI，1.001-1.034；P =.036；仅限于奥沙利铂治疗患者的分析）的可能性增加相关。较低的 BMI 与所有级别贫血（OR，0.975；95%CI，0.956-0.995；P =.015）、高级别贫血（OR，0.941；95%CI，0.890-0.994；P =.030）、所有级别中性粒细胞减少症（OR，0.983；95%CI，0.968-0.999；P =.034）和高级别中性粒细胞减少症（OR，0.962；95%CI，0.945-0.979；P<.001）的可能性增加相关。在多变量 Cox 回归模型中，较高的 BMI 似乎也与更好的总生存期相关（连续变量的风险比：0.977；95%CI，0.967-0.988；P<.001）。
较低的 BMI 与血液学毒性（贫血和中性粒细胞减少症）的风险增加相关，而较高的 BMI 可能与恶心、呕吐和周围神经病变的风险增加相关。较高的 BMI 似乎与转移性 CRC 患者的总体生存率提高有关。
