Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
Surg Today. 2024 Apr;54(4):340-346. doi: 10.1007/s00595-023-02737-2. Epub 2023 Aug 17.
Older patients are more likely to encounter difficulties receiving chemotherapy, but the factors involved in the continuation of chemotherapy in these patients remain unclear. We investigated the importance of muscle mass as a factor involved in delivering a sufficient dose of postoperative S-1 adjuvant chemotherapy (ACT) to older patients with gastric cancer.
The subjects of this study were 79 patients aged ≥ 65 years with stage II/III gastric adenocarcinoma, who underwent curative gastrectomy and received S-1 ACT.
The overall median relative dose intensity (RDI) was 75.0% (18.8-93.5%). Patients were divided into two groups for receiver operating characteristic analysis according to the cutoff value. Significantly more patients in the high skeletal muscle index (SMI) group achieved > 62% RDI of S-1 ACT (p = 0.03). Conversely, more patients in the low SMI group suffered from S-1-induced nausea (p = 0.03) and discontinued chemotherapy because of adverse events (p = 0.02). Multivariate analysis identified low SMI as an independent factor for insufficient S-1 dose delivery (p = 0.03, hazard ratio = 2.87).
Preoperative SMI is an indicator of the low-dose intensity of S-1 ACT in older patients following curative gastrectomy.
老年患者在接受化疗时更有可能遇到困难，但这些患者继续化疗的相关因素仍不清楚。我们研究了肌肉质量作为一个因素的重要性，该因素涉及为老年胃癌患者提供足够剂量的术后 S-1 辅助化疗（ACT）。
本研究的对象是 79 名年龄≥65 岁的 II/III 期胃腺癌患者，他们接受了根治性胃切除术并接受了 S-1 ACT。
总体中位相对剂量强度（RDI）为 75.0%（18.8-93.5%）。根据截断值，患者被分为两组进行受试者工作特征分析。高骨骼肌指数（SMI）组有更多的患者达到了 S-1 ACT 的 RDI>62%（p=0.03）。相反，低 SMI 组更多的患者出现了 S-1 诱导的恶心（p=0.03）和因不良事件而停止化疗（p=0.02）。多变量分析确定低 SMI 是 S-1 剂量不足的独立因素（p=0.03，风险比=2.87）。
术前 SMI 是根治性胃切除术后老年患者 S-1 ACT 低剂量强度的指标。
