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肌肉减少症与放疗或放化疗后食管鳞癌患者的预后相关。

Sarcopenia is associated with prognosis in patients with esophageal squamous cell cancer after radiotherapy or chemoradiotherapy.

机构信息

Department of Radiation Oncology, School of Medicine, Shandong University, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, Shandong, People's Republic of China.

Hefei Cancer Hospital, Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, 230031, People's Republic of China.

出版信息

BMC Gastroenterol. 2022 Apr 30;22(1):211. doi: 10.1186/s12876-022-02296-9.

Abstract

BACKGROUND

This study aimed to determine the prognostic value of the sarcopenia on the progression free survival (PFS) and overall survival (OS) of esophageal squamous cell cancer (ESCC) patients who received radiotherapy (RT) or chemoradiotherapy (CRT).

METHODS

Data on clinicopathological characteristics and nutritional parameters were analyzed and correlated with PFS and OS, retrospectively. Skeletal muscle, subcutaneous, visceral and total fat tissue cross-sectional areas were evaluated on CT images at the midpoint of the 3rd lumbar vertebrae. A total of 213 patients were enrolled in this study.

RESULTS

Sarcopenia was significantly associated with subcutaneous fat content. The univariate analysis demonstrated that OS was superior in patients with non-sarcopenia, non-alcohol, NRI ≥ 100, albumin ≥ 40 g/L, TATI > 83.0, SATI > 27.8, VATI > 49, non-anemia, cervical and upper-thoracic ESCC, T stage 1-2, N stage 0-1 and TNM stage I-II. In the multivariate analysis, sarcopenia, albumin, N stage and TNM stage were identified as independent prognostic factors of survival. This study demonstrated that sarcopenia was related to worse PFS and OS in patients with ESCC who received RT or CRT.

CONCLUSIONS

Sarcopenia is considered to be a useful predictor in patients with ESCC who received RT or CRT. This study also provided a conceptual basis for further prospective research on the application of the sarcopenia for patients receiving RT or CRT for intermediate- and advanced-stage ESCC.

摘要

背景

本研究旨在确定骨骼肌减少症对接受放疗(RT)或放化疗(CRT)的食管鳞癌(ESCC)患者无进展生存期(PFS)和总生存期(OS)的预后价值。

方法

回顾性分析临床病理特征和营养参数与 PFS 和 OS 的关系。在第 3 腰椎中点的 CT 图像上评估骨骼肌、皮下、内脏和总脂肪组织的横截面积。本研究共纳入 213 例患者。

结果

骨骼肌减少症与皮下脂肪含量显著相关。单因素分析显示,非骨骼肌减少症、非饮酒、NRI≥100、白蛋白≥40g/L、TATI>83.0、SATI>27.8、VATI>49、非贫血、颈胸上段 ESCC、T 分期 1-2、N 分期 0-1 和 TNM 分期 I-II 的患者 OS 较好。多因素分析显示,骨骼肌减少症、白蛋白、N 分期和 TNM 分期是生存的独立预后因素。本研究表明,在接受 RT 或 CRT 的 ESCC 患者中,骨骼肌减少症与较差的 PFS 和 OS 相关。

结论

骨骼肌减少症被认为是接受 RT 或 CRT 的 ESCC 患者的有用预测指标。本研究还为进一步研究接受 RT 或 CRT 的中晚期 ESCC 患者的骨骼肌减少症应用提供了概念基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fb5/9063365/0bac2afabeb4/12876_2022_2296_Fig1_HTML.jpg

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