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基于CT的身体成分与结直肠癌幸存者长期化疗引起的周围神经病变有关吗?

Is CT-based body composition associated with long-term chemotherapy-induced peripheral neuropathy in colorectal cancer survivors?

作者信息

Smit Debbie, Mols Floortje, Bonhof Cynthia S, Bours Martijn J L, Vreugdenhil Gerard, Beijer Sandra

机构信息

CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.

Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.

出版信息

Support Care Cancer. 2022 Jul;30(7):6071-6078. doi: 10.1007/s00520-022-07036-z. Epub 2022 Apr 13.

Abstract

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect among colorectal cancer (CRC) survivors, and the severity is mainly dependent on the chemotherapy dose. Nowadays, chemotherapy dose is based on body surface area, while determination based on more accurate measures of body composition may be better. This study aimed to investigate the association between body composition and long-term CIPN among CRC survivors 2-11 years after diagnosis.

METHODS

Data from CRC survivors from the population-based PROFILES registry were used. Survivors were included when they received chemotherapy, filled in the EORTC QLQ-CIPN20, and had a computed tomography (CT) scan at diagnosis (n = 202). Total, sensory, motor, and autonomic CIPN were based upon the EORTC QLQ-CIPN20. The abdominal CT scans were used to determine skeletal muscle index (SMI), skeletal muscle density (SMD), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and total adipose tissue (TAT). Logistic regression was used to analyze the association between CIPN outcomes and body composition variables.

RESULTS

CIPN was experienced by 64% of the CRC survivors several years after chemotherapy. More SAT was associated with a higher odds of reporting total CIPN (OR = 1.01 95% CI 1.00-1.01, p = 0.01), motor CIPN (OR = 1.01 95% CI 1.00-1.01, p = 0.01), and sensory CIPN (OR = 1.01 95% CI 1.00-1.01, p = 0.04). No associations of other body composition parameters with CIPN were observed.

CONCLUSION

Only SAT was associated with total, motor, and sensory CIPN. Based on these results, we cannot conclude that determining the chemotherapy dose based on body composition is preferred over determining the chemotherapy dose based on body surface to prevent CIPN. More research is needed to assess associations of body composition with CIPN, a common side effect of chemotherapy.

摘要

背景

化疗引起的周围神经病变(CIPN)是结直肠癌(CRC)幸存者中常见的副作用,其严重程度主要取决于化疗剂量。目前,化疗剂量是基于体表面积确定的,而基于更精确的身体成分测量来确定剂量可能会更好。本研究旨在调查诊断后2至11年的CRC幸存者身体成分与长期CIPN之间的关联。

方法

使用来自基于人群的PROFILES登记处的CRC幸存者数据。当幸存者接受化疗、填写欧洲癌症研究与治疗组织(EORTC)QLQ-CIPN20问卷且在诊断时进行了计算机断层扫描(CT)时纳入研究(n = 202)。基于EORTC QLQ-CIPN20评估总的、感觉性、运动性和自主性CIPN。腹部CT扫描用于确定骨骼肌指数(SMI)、骨骼肌密度(SMD)、内脏脂肪组织(VAT)、皮下脂肪组织(SAT)和总脂肪组织(TAT)。采用逻辑回归分析CIPN结局与身体成分变量之间的关联。

结果

64%的CRC幸存者在化疗数年之后出现了CIPN。更多的SAT与报告总的CIPN(比值比[OR]=1.01,95%置信区间[CI]为1.00 - 1.01,p = 0.01)、运动性CIPN(OR = 1.01,95% CI为1.00 - 1.01,p = 0.01)和感觉性CIPN(OR = 1.01,95% CI为1.00 - 1.01,p = 0.04)的较高几率相关。未观察到其他身体成分参数与CIPN之间存在关联。

结论

仅SAT与总的、运动性和感觉性CIPN相关。基于这些结果,我们无法得出基于身体成分确定化疗剂量比基于体表面积确定化疗剂量更能预防CIPN的结论。需要更多研究来评估身体成分与CIPN(化疗的一种常见副作用)之间的关联。

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