Department of Medical Oncology, Godinot Cancer Institute, 51100 Reims, France.
Department of Gastroenterology and Digestive Oncology, Université de Reims Champagne-Ardenne, CHU Reims, 51100 Reims, France.
Nutrients. 2022 Oct 22;14(21):4448. doi: 10.3390/nu14214448.
In the FIGHTDIGO study, digestive cancer patients with dynapenia experienced more chemotherapy-induced neurotoxicities. FIGHTDIGOTOX aimed to evaluate the relationship between pre-therapeutic handgrip strength (HGS) and chemotherapy-induced dose-limiting toxicity (DLT) or all-grade toxicity in digestive cancer patients. HGS measurement was performed with a Jamar dynamometer. Dynapenia was defined according to EWGSOP2 criteria (<27 kg (men); <16 kg (women)). DLT was defined as any toxicity leading to dose reduction, treatment delay, or permanent discontinuation. We also performed an exploratory analysis in patients below the included population’s median HGS. A total of 244 patients were included. According to EWGSOP2 criteria, 23 patients had pre-therapeutic dynapenia (9.4%). With our exploratory median-based threshold (34 kg for men; 22 kg for women), 107 patients were dynapenic (43.8%). For each threshold, dynapenia was not an independent predictive factor of overall DLT and neurotoxicity. Dynapenic patients according to EWGSOP2 definition experienced more hand-foot syndrome (p = 0.007). Low HGS according to our exploratory threshold was associated with more all-grade asthenia (p = 0.014), anemia (p = 0.006), and asthenia with DLT (p = 0.029). Pre-therapeutic dynapenia was not a predictive factor for overall DLT and neurotoxicity in digestive cancer patients but could be a predictive factor of chemotherapy-induced anemia and asthenia. There is a need to better define the threshold of dynapenia in cancer patients.
在 FIGHTDIGO 研究中，患有 Dynapenia 的消化道癌症患者经历了更多的化疗引起的神经毒性。FIGHTDIGOTOX 旨在评估治疗前握力（HGS）与消化道癌症患者化疗引起的剂量限制毒性（DLT）或所有级别毒性之间的关系。使用 Jamar 测力计进行 HGS 测量。根据 EWGSOP2 标准，将 Dynapenia 定义为<27 kg（男性）；<16 kg（女性）。DLT 定义为任何导致剂量减少、治疗延迟或永久停药的毒性。我们还在包括人群 HGS 中位数以下的患者中进行了探索性分析。共纳入 244 例患者。根据 EWGSOP2 标准，23 例患者在治疗前患有 Dynapenia（9.4%）。根据我们的探索性基于中位数的阈值（男性 34 公斤；女性 22 公斤），107 例患者 Dynapenia（43.8%）。对于每个阈值，Dynapenia 都不是总 DLT 和神经毒性的独立预测因素。根据 EWGSOP2 定义，患有 Dynapenia 的患者更易发生手足综合征（p = 0.007）。根据我们的探索性阈值，低 HGS 与更严重的所有级别乏力（p = 0.014）、贫血（p = 0.006）和乏力与 DLT（p = 0.029）相关。治疗前 Dynapenia 不是消化道癌症患者总 DLT 和神经毒性的预测因素，但可能是化疗引起的贫血和乏力的预测因素。有必要更好地定义癌症患者 Dynapenia 的阈值。
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