Division of Medical Oncology, Department of Medicine, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand.
Division of Geriatrics, Department of Medicine, Faculty of Medicine Siriraj Hospital, 26685Mahidol University, Bangkok, Thailand.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221106529. doi: 10.1177/15330338221106529.
Low muscle mass is associated with worse cancer treatment outcomes. Although dual-energy X-ray absorptiometry or computerized tomography-based analysis have both been widely studied in this clinical setting, studies in the use of bioelectrical impedance analysis (BIA) remain limited. The aim of this prospective study was to investigate for association between body composition estimated by BIA and hematologic adverse events in early-stage breast cancer patients receiving chemotherapy. A total of 144 female patients were enrolled. Before the first cycle of chemotherapy, body weight and fat-free mass were measured by a BIA device and then those values were converted into body mass index and fat-free mass index. Association between fat-free mass index and composite adverse events (CAEs), including grade 4 neutropenia, febrile neutropenia, or relative dose intensity <85%, was explored. CAEs occurred in 85 patients (59%), and point biserial correlation showed an inverse correlation between the fat-free mass index and CAE. No included patients were sarcopenic (fat-free mass index <11.4 kg/m). Receiver operating characteristic curve analysis revealed <14.85 kg/m as the cutoff value indicating a low fat-free mass index. Using this cutoff, 85 patients were classified as having a low fat-free mass index, and 62 of those patients (72.9%) had CAE (relative risk: 1.86, < .001). After adjusting for other factors, a low fat-free mass index was found to be independently associated with a high CAE (adjusted odds ratio: 4.562, 95% CI: 2.162-9.627, < .001). Low fat-free mass index is an independent predictor of increased risk of hematologic adverse events in early-stage breast cancer patients receiving chemotherapy. Estimation of fat-free mass index by BIA may identify at-risk patients so that interventions can be considered to improve treatment outcomes.
肌肉量低与癌症治疗结局较差相关。虽然双能 X 射线吸收法或基于计算机断层扫描的分析在这一临床环境中都得到了广泛研究，但生物电阻抗分析（BIA）的应用研究仍然有限。本前瞻性研究旨在探讨 BIA 估计的身体成分与接受化疗的早期乳腺癌患者血液学不良事件之间的关联。
共纳入 144 名女性患者。在化疗的第一个周期前，使用 BIA 设备测量体重和去脂体重，然后将这些值转换为体重指数和去脂体重指数。探讨了去脂体重指数与复合不良事件（CAE），包括 4 级中性粒细胞减少症、发热性中性粒细胞减少症或相对剂量强度<85%之间的关系。85 例患者（59%）发生 CAE，两点二项相关分析显示去脂体重指数与 CAE 呈负相关。无纳入患者出现肌肉减少症（去脂体重指数<11.4kg/m）。受试者工作特征曲线分析显示，<14.85kg/m 为低去脂体重指数的截断值。使用该截断值，将 85 例患者分为低去脂体重指数组，其中 62 例患者（72.9%）发生 CAE（相对风险：1.86，<0.001）。在调整其他因素后，低去脂体重指数与 CAE 高风险独立相关（调整后的优势比：4.562，95%CI：2.162-9.627，<0.001）。
低去脂体重指数是接受化疗的早期乳腺癌患者发生血液学不良事件风险增加的独立预测因素。BIA 估计的去脂体重指数可识别高危患者，以便考虑干预措施以改善治疗结局。
