Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Graduate School of Medical Sciences, Research Institute for Diseases of the Chest, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
J Cancer Res Clin Oncol. 2020 May;146(5):1217-1225. doi: 10.1007/s00432-020-03146-5. Epub 2020 Feb 5.
The aim of this study was to elucidate the clinical impact of skeletal muscle area (SMA) in patients with non-small cell lung cancer (NSCLC) treated with anti-programmed cell death-1 (PD-1) inhibitors.
Univariate and multivariate analyses were performed on data of 103 patients with advanced or recurrent NSCLC treated with anti-PD-1 inhibitors. The SMA was measured at the level of the third lumbar vertebral (L3) on computed tomography images using OsiriX software (32-bit, version 5.8; OsiriX, Geneva, Switzerland). The L3 muscle index (cm/m) was defined as the SMA (cm) at the L3 level divided by the height (m) squared.
L3 muscle index was an independent predictor of both progression-free (P = 0.0399) and overall survival (P = 0.0155). Moreover, the disease control rate was significantly lower in the L3 muscle index group (49.0% [25/51]) than in the L3 muscle index group (73.1% [38/52]; P = 0.0117). However, there was no significant difference between the response rates of the L3 muscle index group (21.6% [11/51]) and L3 muscle index group (32.7% [17/52]; P = 0.2031).
L3 muscle index is an independent predictor of worse outcomes in NSCLC patients treated with anti-PD-1 inhibitors.
本研究旨在阐明骨骼肌面积（SMA）在接受抗程序性细胞死亡-1（PD-1）抑制剂治疗的非小细胞肺癌（NSCLC）患者中的临床意义。
对 103 例接受抗 PD-1 抑制剂治疗的晚期或复发性 NSCLC 患者的数据进行单因素和多因素分析。使用 OsiriX 软件（32 位，版本 5.8；OsiriX，瑞士日内瓦）在 CT 图像的第三腰椎（L3）水平测量 SMA。L3 肌肉指数（cm/m）定义为 L3 水平的 SMA（cm）除以身高（m）的平方。
L3 肌肉指数是无进展生存期（P=0.0399）和总生存期（P=0.0155）的独立预测因素。此外，L3 肌肉指数 组的疾病控制率显著低于 L3 肌肉指数 组（49.0%[25/51]）（P=0.0117）。然而，L3 肌肉指数 组（21.6%[11/51]）和 L3 肌肉指数 组（32.7%[17/52]）的缓解率无显著差异（P=0.2031）。
L3 肌肉指数是接受抗 PD-1 抑制剂治疗的 NSCLC 患者预后不良的独立预测因素。
