Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine.
Department of Gastroenterology and Hepatology, Fujita Health University.
Nutr Cancer. 2022;74(9):3118-3127. doi: 10.1080/01635581.2022.2049322. Epub 2022 Mar 12.
Changes in body composition parameters are important prognostic factors in hepatocellular carcinoma (HCC) treatment. This study aimed to assess the clinical impact of early changes in body composition during lenvatinib (LEN) treatment on its time to treatment failure (TTF) for patients with advanced HCC.
In this retrospective study, we enrolled 65 patients who were administered LEN as the first-line treatment for unresectable HCC and evaluated the body composition change using computed tomography. We focused on the body composition change after 2 weeks of LEN treatment and assessed its impact on TTF and prognosis.
Significant changes in body composition were observed during 14 weeks of LEN treatment. Among these changes, mean-skeletal muscle attenuation (SMA) decreased significantly within 2 weeks ( = 0.004) without symptoms or changes in the other parameters. In multivariate analysis, this early change in mean-SMA after LEN treatment was a significant predictor of time to treatment failure (HR: 2.67, 95%CI: 1.338-5.081, = 0.005) in patients with HCC.
This study revealed that LEN treatment induces a change in the skeletal muscle asymptomatically for a short period, and evaluation of this change may help to predict the TTF of LEN treatment in patients with HCC.
Supplemental data for this article is available online at https://doi.org/10.1080/01635581.2022.2049322 .
体成分参数的变化是肝细胞癌（HCC）治疗的重要预后因素。本研究旨在评估仑伐替尼（LEN）治疗期间体成分早期变化对晚期 HCC 患者治疗失败时间（TTF）的临床影响。
在这项回顾性研究中，我们纳入了 65 名接受 LEN 作为不可切除 HCC 一线治疗的患者，并使用计算机断层扫描评估体成分变化。我们关注 LEN 治疗后 2 周的体成分变化，并评估其对 TTF 和预后的影响。
在 14 周的 LEN 治疗期间观察到体成分的显著变化。在这些变化中，2 周内平均骨骼肌衰减（SMA）显著下降（ = 0.004），而没有出现症状或其他参数的变化。在多变量分析中，LEN 治疗后平均-SMA 的早期变化是 HCC 患者治疗失败时间的显著预测因子（HR：2.67，95%CI：1.338-5.081， = 0.005）。
本研究表明，LEN 治疗在短时间内会引起骨骼肌的无症状变化，评估这种变化可能有助于预测 HCC 患者 LEN 治疗的 TTF。
