Department of Radiation Oncology, Fujian Medical University Cancer Hospital, 66552Fujian Cancer Hospital, Fuzhou, China.
Cancer Control. 2022 Jan-Dec;29:10732748221126935. doi: 10.1177/10732748221126935.
To assess the effect of pretreatment body mass index (BMI) and the extent of change in BMI (ΔBMI) during the treatment course on the treatment outcomes in patients with nasopharyngeal carcinoma (NPC) receiving volumetric modulated arc therapy (VMAT).
Data pertaining to 498 consecutive NPC patients with stage I-IVA disease who received VMAT between January 2010 and November 2011 at a single center were retrospectively analyzed. Univariate Kaplan-Meier and multivariate Cox regression analyses were used to evaluate the prognostic significance of pretreatment BMI and ΔBMI. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off point of ΔBMI.
The 5-year loco-regional failure-free (L-FFR), distant failure-free survival (D-FFR), disease-free survival (DFS), and overall survival (OS) rates were 90.6%, 83.7%, 71.5% and 79.3%, respectively. The 5-year L-FFR, D-FFR, DFS, OS rates for NPC patients with ΔBMI ≤1 kg/m vs ΔBMI >1 kg/m were 92.3% vs 89.3% ( = .137), 90.9% vs 78.5% ( < .001), 80.4% vs 65.1% ( < .001), and 88.0% vs 73.0% ( < .001), respectively. ΔBMI >1 kg/m was an independent predictor of D-FFR ( = .002), DFS ( = .002), and OS ( = .001).
ΔBMI during treatment course may have a significant impact on the prognosis of NPC patients receiving VMAT.
评估鼻咽癌患者接受容积旋转调强放疗（VMAT）治疗过程中预处理体重指数（BMI）和 BMI 变化程度（ΔBMI）对治疗结果的影响。
回顾性分析 2010 年 1 月至 2011 年 11 月在一家中心接受 VMAT 治疗的 498 例Ⅰ-ⅣA 期鼻咽癌患者的数据。采用单变量 Kaplan-Meier 和多变量 Cox 回归分析评估预处理 BMI 和ΔBMI 的预后意义。采用受试者工作特征（ROC）曲线分析确定ΔBMI 的最佳截断点。
5 年局部无复发生存率（L-FFR）、远处无复发生存率（D-FFR）、无病生存率（DFS）和总生存率（OS）分别为 90.6%、83.7%、71.5%和 79.3%。ΔBMI≤1kg/m2与ΔBMI>1kg/m2的鼻咽癌患者 5 年 L-FFR、D-FFR、DFS 和 OS 率分别为 92.3%比 89.3%（ =.137）、90.9%比 78.5%（<.001）、80.4%比 65.1%（<.001）和 88.0%比 73.0%（<.001）。ΔBMI>1kg/m2是 D-FFR（=.002）、DFS（=.002）和 OS（=.001）的独立预测因子。
治疗过程中ΔBMI 可能对接受 VMAT 治疗的鼻咽癌患者的预后有重大影响。
