Sutandyo Noorwati, Hanafi Arif Riswahyudi, Jayusman Achmad Mulawarman, Kurniawati Sri Agustini, Hanif Muhamad Alfin
Division of Hematology and Medical Oncology, Department of Internal Medicine, Dharmais National Cancer Hospital, Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Int J Gen Med. 2023 Jan 6;16:85-93. doi: 10.2147/IJGM.S382577. eCollection 2023.
Most patients with non-small cell lung cancer (NSCLC) are diagnosed in advanced-stage disease and therefore have poor overall survival. It remains unclear whether nutritional status affects response rate and overall survival in NSCLC patients. This study aimed to evaluate the association of nutritional status with treatment response and overall survival in patients with advanced stage of NSCLC.
Patients aged ≥18 years with stage II-IV NSCLC (January-June 2018) in a national cancer center in Indonesia were enrolled in this study. The patients were followed up for 2 years since NSCLC diagnosis was established. Clinical data including age, sex, histology of cancer, disease stage, cachexia, and weight status before chemotherapy were reviewed and analyzed. Logistic regression and Cox regression analyses were performed.
A total of 174 patients (71% males, mean age = 58±9.4 years) was included. Complete response was found in <1% patients, partial response 41%, stable disease 33%, and progressive disease 25%. Median survival was 12 months (95% CI: 11-13 months). Mortality rate was 5.7 per 100 person-months. Poor survival was associated with being males (HR: 1.77, 95% CI: 1.15-2.72, P = 0.009), and overweight or obesity (HR 1.67, 95% CI: 1.04-2.69, P = 0.034). These associations were independent of sex, age, staging, histopathology, performance status and D-dimer level at baseline. Cachexia and BMI at baseline were not associated with treatment response.
Males and having overweight or obesity are independently associated with lower survival in patients with advanced stage of NSCLC undergoing platinum-based chemotherapy.
大多数非小细胞肺癌（NSCLC）患者在疾病晚期被诊断出来，因此总体生存率较差。营养状况是否会影响NSCLC患者的缓解率和总体生存率仍不清楚。本研究旨在评估晚期NSCLC患者营养状况与治疗反应及总体生存率之间的关联。
纳入印度尼西亚一家国家癌症中心2018年1月至6月年龄≥18岁的II-IV期NSCLC患者。自确诊NSCLC起对患者进行2年随访。回顾并分析包括年龄、性别、癌症组织学类型、疾病分期、恶病质以及化疗前体重状况等临床数据。进行逻辑回归和Cox回归分析。
共纳入174例患者（71%为男性，平均年龄=58±9.4岁）。<1%的患者达到完全缓解，部分缓解41%，疾病稳定33%，疾病进展25%。中位生存期为12个月（95%CI：11-13个月）。死亡率为每100人月5.7例。生存较差与男性（HR：1.77，95%CI：1.15-2.72，P = 0.009）以及超重或肥胖（HR 1.67，95%CI：1.04-2.69，P = 0.034）有关。这些关联独立于基线时的性别、年龄、分期、组织病理学、体能状态和D-二聚体水平。基线时的恶病质和BMI与治疗反应无关。
男性以及超重或肥胖与接受铂类化疗的晚期NSCLC患者较低的生存率独立相关。
