Qiukui Hao, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China,
J Nutr Health Aging. 2021;25(7):878-882. doi: 10.1007/s12603-021-1633-3.
To assess the predictability value of Sarcopenia index( (SI, serum creatinine value/cystatin C value×100) in determining potential chemotherapy-induced undesirable reactions and eventual death of older patients diagnosed with stage III or IV of non-small cell lung cancer (NSCLC).
General information was retrieved from health records and mortality data was obtained by phone interview. Serum Cr and CysC levels were measured before chemotherapy. The endpoints recorded were chemotherapy-induced undesirable reactions and mortality from any causes. Logit regression analysis was employed for the analysis of correlation between the SI and short-term adverse reactions to chemotherapy. Cox regression analysis was employed to analyze correlation between the SI and mortality.
In this study, 664 NSCLC patients were enrolled. Among them, 83.13% were diagnosed with adenocarcinoma lung cancer and 16.87% with squamous cell carcinoma lung cancer. As of March 1, 2019, 486 patients died, including 361(74.28%) males and 125 (25.72%) females. After the first course of chemotherapy, the proportion of short-term adverse reactions, including bone marrow suppression, digestive reactions, all infection, liver function impairment, and other adverse reactions (non-infectious fever or rashes) was 16%, 4.7%, 7.4, %, 6.6%, and 2.11%, respectively. After adjusting for confounding factors, there was no association between the SI and adverse reactions. We found that high SI was independently associated with a lower risk of mortality after adjusting for confounding factors in females (HR=0.593,95% CI: 0.382-0.92; p=0.02). There was no marked association existed between the SI and mortality in males.
Among patients with stage III or IV non-small cell lung cancer, the SI is associated with mortality in females, but not in males.
评估肌少症指数（（SI，血清肌酐值/胱抑素 C 值×100）在预测 III 期或 IV 期非小细胞肺癌（NSCLC）老年患者潜在化疗不良反应和最终死亡方面的预测价值。
从健康记录中检索一般信息，并通过电话访谈获得死亡率数据。在化疗前测量血清 Cr 和 CysC 水平。记录的终点是化疗引起的不良反应和任何原因导致的死亡。采用逻辑回归分析 SI 与化疗短期不良反应之间的相关性。采用 Cox 回归分析 SI 与死亡率之间的相关性。
本研究纳入了 664 例 NSCLC 患者。其中，83.13%诊断为肺腺癌，16.87%诊断为肺鳞癌。截至 2019 年 3 月 1 日，486 例患者死亡，其中 361 例（74.28%）为男性，125 例（25.72%）为女性。在第一疗程化疗后，短期不良反应的比例包括骨髓抑制、消化反应、所有感染、肝功能损害和其他不良反应（非感染性发热或皮疹）分别为 16%、4.7%、7.4%、6.6%和 2.11%。在调整混杂因素后，SI 与不良反应之间没有关联。我们发现，在调整混杂因素后，高 SI 与女性死亡率降低独立相关（HR=0.593，95%CI：0.382-0.92；p=0.02）。在男性中，SI 与死亡率之间没有明显的关联。
在 III 期或 IV 期非小细胞肺癌患者中，SI 与女性的死亡率相关，但与男性无关。
