Rizzo Stefania, Scala Isabel, Robayo Angela Rodriguez, Cefalì Marco, De Dosso Sara, Cappio Stefano, Xhepa Genti, Del Grande Filippo
Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
Facoltà di Scienze biomediche, Università della Svizzera Italiana, Lugano, Switzerland.
Front Oncol. 2022 Sep 29;12:974116. doi: 10.3389/fonc.2022.974116. eCollection 2022.
The objective of this systematic review was to assess associations between quantitative body composition measures extracted from imaging examinations and chemotherapy-related toxicity in pancreatic cancer patients. A secondary objective was to evaluate the different definitions of sarcopenia across included studies.
This systematic review was conducted according to the PRISMA statement. A comprehensive literature search of three electronic databases was performed by two authors. For each eligible article, information was collected concerning the clinical setting; basic study; population characteristics; technical; body composition features evaluated; CA 19.9 tumor marker levels; chemotherapy drugs administered; toxicities (hematologic, nausea/vomiting, diarrhea, neuropathy, reduction of number of cycles, overall toxicity); association of body composition values with toxicities. The overall quality of the included studies was critically evaluated.
After the initial retrieval of 1137 articles, the systematic review included 12 articles (1/12 in the neo-adjuvant setting; 2/12 in the adjuvant setting; 3/12 in the metastatic setting; 2/12 in the unresectable setting; the other 4/12 included more than one clinical setting). The number of patients included ranged between 17 and 251; mean/median age ranged between 63 and 77 years; the percentage of sarcopenic patients ranged between 23 and 76%. The most frequent body composition parameter evaluated was skeletal muscle index (11/12). Chemotherapy regimens included gemcitabine (as monotherapy or in combination with other drugs); FOLFIRINOX and S-1. Among the trials including gemcitabine, 2/9 demonstrated an association with toxicity, whereas 7/9 did not; among those including FOLFIRINOX, one demonstrated associated toxicity whereas the others did not. Altogether, 4/12 papers demonstrated an association between the body composition values and the development of chemotherapy-related toxicities.
There is a wide variability of results about the association of body composition and chemotherapy-related toxicity in PC patients. Furthermore, cut-off values to define sarcopenia in PC patients are not yet uniformly defined.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337753, identifier CRD42022337753.
本系统评价的目的是评估从影像学检查中提取的定量身体成分测量值与胰腺癌患者化疗相关毒性之间的关联。次要目的是评估纳入研究中肌肉减少症的不同定义。
本系统评价按照PRISMA声明进行。由两位作者对三个电子数据库进行全面的文献检索。对于每一篇符合条件的文章，收集了以下方面的信息：临床背景；基础研究；人群特征；技术；评估的身体成分特征；CA 19.9肿瘤标志物水平；使用的化疗药物；毒性（血液学毒性、恶心/呕吐、腹泻、神经病变、周期数减少、总体毒性）；身体成分值与毒性的关联。对纳入研究的整体质量进行了严格评估。
在初步检索到的1137篇文章中，本系统评价纳入了12篇文章（新辅助治疗背景下1/12；辅助治疗背景下2/12；转移性治疗背景下3/12；不可切除治疗背景下2/12；另外4/12包括不止一种临床背景）。纳入的患者数量在17至251之间；平均/中位年龄在63至77岁之间；肌肉减少症患者的百分比在23%至76%之间。评估最频繁的身体成分参数是骨骼肌指数（11/12）。化疗方案包括吉西他滨（单药治疗或与其他药物联合使用）；FOLFIRINOX和S-1。在包括吉西他滨的试验中，2/9显示与毒性有关联，而7/9没有；在包括FOLFIRINOX的试验中，1个显示有关联的毒性，而其他试验没有。总共，4/12篇论文显示身体成分值与化疗相关毒性的发生之间存在关联。
关于胰腺癌患者身体成分与化疗相关毒性的关联，结果存在很大差异。此外，尚未统一确定胰腺癌患者肌肉减少症的截断值。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337753，标识符CRD42022337753。
