He Yan, Zhang Yu, Chong Weelic, Pei Yiyan, Zhang Renjie, Liu Zheran, Yu Jiayi, Peng Xingchen, Fang Fang
West China Hospital, Sichuan University, Chengdu, China.
Evidence-Based Medicine Center, Affiliated Hospital of Chengdu University, Chengdu, China.
Front Nutr. 2022 Jul 1;9:851629. doi: 10.3389/fnut.2022.851629. eCollection 2022.
The prognostic role of body mass index (BMI) in patients with brain metastases is controversial. We aim to investigate the impact of BMI on prognosis and anti-cancer therapy effectiveness in brain metastases.
Patients diagnosed with brain metastases between Oct 2010 and July 2019 were followed for mortality through April 2021. The prognostic role of BMI on overall survival was assessed by a restricted cubic spline (RCS) using a flexible model to visualize the relationship between the BMI values and hazard ratios of all-cause mortality, followed by a cox regression model. The disparity of survival outcomes in patients receiving anti-cancer therapies or those did not was evaluated according to the classification of BMI.
A total of 2,466 patients were included in the analysis, including 241 in the underweight (BMI < 18.5 kg/m) group, 1,503 in the normal weight group (BMI 18.5-23.9 kg/m), and 722 in the overweight (BMI ≥ 24 kg/m) group. Relative to the normal weight group, underweight patients were associated with poor prognosis (adjusted HR 1.25, 95% CI 1.07-1.46, = 0.005). However, those in the overweight group showed similar overall survival when compared to the normal-weight group. Patients with weight loss were associated with a higher risk of mortality compared with patients without significant weight loss. In underweight patients, there was an insignificant difference in survival outcomes whether they received anti-cancer therapies or not.
Underweight and significant weight loss were associated with poor prognosis in brain metastases. Meanwhile, anti-cancer therapies did not significantly improve overall survival in patients with underweight. These findings suggest that improving nutrition to maintain body weight is critical for patients with brain metastases.
体重指数（BMI）在脑转移瘤患者中的预后作用存在争议。我们旨在研究BMI对脑转移瘤患者预后及抗癌治疗效果的影响。
对2010年10月至2019年7月期间诊断为脑转移瘤的患者进行随访，直至2021年4月以了解死亡率。使用受限立方样条（RCS）通过灵活模型评估BMI对总生存期的预后作用，以可视化BMI值与全因死亡率风险比之间的关系，随后进行cox回归模型分析。根据BMI分类评估接受抗癌治疗或未接受抗癌治疗患者生存结果的差异。
共有2466例患者纳入分析，其中体重过轻（BMI<18.5kg/m）组241例，正常体重组（BMI 18.5 - 23.9kg/m）1503例，超重（BMI≥24kg/m）组722例。与正常体重组相比，体重过轻的患者预后较差（校正风险比1.25，95%置信区间1.07 - 1.46，P = 0.005）。然而，超重组与正常体重组相比总体生存期相似。与无明显体重减轻的患者相比，体重减轻的患者死亡风险更高。在体重过轻的患者中，无论是否接受抗癌治疗，生存结果均无显著差异。
体重过轻和显著体重减轻与脑转移瘤患者预后不良相关。同时，抗癌治疗并未显著改善体重过轻患者的总体生存期。这些发现表明，改善营养以维持体重对脑转移瘤患者至关重要。
