Rinninella Emanuele, Strippoli Antonia, Cintoni Marco, Raoul Pauline, Vivolo Raffaella, Di Salvatore Mariantonietta, Genco Enza, Manfredi Riccardo, Bria Emilio, Tortora Giampaolo, Gasbarrini Antonio, Pozzo Carmelo, Mele Maria Cristina
UOC di Nutrizione Clinica, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Nutrients. 2021 Mar 16;13(3):960. doi: 10.3390/nu13030960.
The impact of the new chemotherapy, fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT) on body composition in gastric cancer (GC) patients remains unknown. We assessed body composition changes of GC patients receiving the FLOT regimen and their impact on treatment outcomes.
Preoperative pre- and post-FLOT computed tomography (CT) scans of advanced GC patients were studied. Lumbar skeletal muscle index (SMI) and adipose indices were calculated before and after FLOT.
A total of 26 patients were identified between April 2019 and January 2020. Nineteen patients were sarcopenic at diagnosis. The mean BMI decreased (from 24.4 ± 3.7 to 22.6 ± 3.1; < 0.0001) as well as the SMI (from 48.74 ± 9.76 to 46.52 ± 9.98; = 0.009) and visceral adipose index (VAI) (from 49.04 ± 31.06 to 41.99 ± 23.91; = 0.004) during preoperative FLOT therapy. BMI, SMI, and VAI variations were not associated with toxicity, Response Evaluation Criteria in Solid Tumors (RECIST), response, delay and completion of perioperative FLOT chemotherapy, and the execution of gastrectomy; a decrease of SMI ≥ 5% was associated with a higher Mandard tumor regression grade ( = 0.01).
Almost three-quarters (73.1%) of GC patients were sarcopenic at diagnosis. Preoperative FLOT was associated with a further reduction in SMI, BMI, and VAI. These changes were not associated with short-term outcomes.
新型化疗方案氟尿嘧啶联合亚叶酸钙、奥沙利铂和多西他赛（FLOT）对胃癌（GC）患者身体成分的影响尚不清楚。我们评估了接受FLOT方案的GC患者的身体成分变化及其对治疗结果的影响。
研究了晚期GC患者术前FLOT治疗前后的计算机断层扫描（CT）。计算FLOT治疗前后的腰椎骨骼肌指数（SMI）和脂肪指数。
2019年4月至2020年1月共纳入26例患者。19例患者诊断时存在肌肉减少症。术前FLOT治疗期间，平均体重指数（BMI）下降（从24.4±3.7降至22.6±3.1；P<0.0001），SMI（从48.74±9.76降至46.52±9.98；P=0.009）和内脏脂肪指数（VAI）（从49.04±31.06降至41.99±23.91；P=0.004）。BMI、SMI和VAI的变化与毒性、实体瘤疗效评价标准（RECIST）、反应、围手术期FLOT化疗的延迟和完成情况以及胃切除术的实施无关；SMI下降≥5%与更高的Mardard肿瘤退缩分级相关（P=0.01）。
近四分之三（73.1%）的GC患者诊断时存在肌肉减少症。术前FLOT与SMI、BMI和VAI的进一步降低相关。这些变化与短期结果无关。
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