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新辅助治疗食管癌患者肌肉减少症与临床结局的相关性。

Association Between Sarcopenia and Clinical Outcomes in Patients With Esophageal Cancer Under Neoadjuvant Therapy.

机构信息

Department of Nursing, Tzu-Chi University, Hualien, Taiwan, R.O.C.

Department of Medical Imaging and Radiological Sciences, Tzu Chi University of Science and Technology, Hualien, Taiwan, R.O.C.

出版信息

Anticancer Res. 2020 Feb;40(2):1175-1181. doi: 10.21873/anticanres.14060.

Abstract

BACKGROUND/AIM: This study aimed to evaluate the association of sarcopenia and Clinical Outcomes with esophageal cancer under neoadjuvant chemoradiotherapy (CRT).

PATIENTS AND METHODS

A retrospective study assessing patients with esophageal cancer who underwent CRT between 2001 and 2014 was conducted in the medical center. Hospital patients' records on sarcopenia and treatment outcomes were statistically analyzed.

RESULTS

The sarcopenia group had significantly lower body mass index than the non-sarcopenia group. CRT-related severe adverse events with mucositis, fever, and neutropenic fever were greater in the sarcopenia group. Overall survival and disease-free survival were significantly better in the non-sarcopenia group. Sarcopenic patients who received nutritional support with enteral access had less severe mucositis. There was no difference in mortality of sarcopenia patients with nutritional support via enteral access or without. Moreover, sarcopenia and advanced tumor stage were independent factors for mortality outcome.

CONCLUSION

Sarcopenia before CRT may be associated with increased toxicities and worse overall survival/ disease-free survival in esophageal cancer patients.

摘要

背景/目的:本研究旨在评估在新辅助放化疗(CRT)下,肌肉减少症与食管癌临床结局的相关性。

患者与方法

对 2001 年至 2014 年间在医疗中心接受 CRT 的食管癌患者进行了回顾性研究。对患者的肌肉减少症和治疗结局的医院病历进行了统计学分析。

结果

肌肉减少症组的体质指数显著低于非肌肉减少症组。肌肉减少症组 CRT 相关的严重不良事件(如黏膜炎、发热和中性粒细胞发热)发生率更高。非肌肉减少症组的总生存率和无病生存率明显更好。经肠内途径接受营养支持的肌肉减少症患者,其黏膜炎严重程度较低。经肠内途径或不经肠内途径给予营养支持的肌肉减少症患者的死亡率无差异。此外,肌肉减少症和晚期肿瘤分期是死亡率的独立影响因素。

结论

在 CRT 之前存在肌肉减少症可能与食管癌患者的毒性增加和总生存率/无病生存率降低有关。

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