Istituto Oncologico Della Svizzera Italiana (IOSI), Ente Ospedaliero Cantonale (EOC), Via Ospedale 1, 6500, Bellinzona, Switzerland.
Institute of Oncology Research (IOR), Via Chiesa 5, Bellinzona, Switzerland.
Radiol Med. 2023 Dec;128(12):1497-1507. doi: 10.1007/s11547-023-01723-5. Epub 2023 Sep 26.
Primary purpose was to assess changes of bone mineral density (BMD) in diffuse large B cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone R-CHOP (like) chemotherapy regimen. Secondary purposes were to assess other body composition features changes and to assess the association of pre-therapy values and their changes over time with survival.
Patients selected underwent R-CHOP(like) regimen for DLBCL, and underwent PET-CT before and after treatment. Main clinical data collected included body mass index, date of last follow-up, date of progression, and date of death. From the low-dose CT images, BMD was assessed at the L1 level; the other body composition values, including muscle and fat distribution, were assessed at the L3 level by using a dedicated software. Descriptive statistics were reported as median and interquartile range, or frequencies and percentages. Statistical comparisons of body composition variables between pre- and post-treatment assessments were performed using the Wilcoxon matched pairs signed rank test. Non-normal distribution of variables was tested with the Shapiro-Wilk test. For qualitative variables, the Fisher exact test was used. Log rank test was used to compare survival between different subgroups of the study population defined by specific body composition cutoffs. The significance level was set at p < 0.05.
Eighty-two patients were included. The mean follow-up was 37.5 ± 21.4 months. A significant difference was found in mean BMD before and after R-CHOP(like) treatment (p < 0.0001). The same trend was observed for mean skeletal muscle area (SMA) (p = 0.004) and mean skeletal muscle index (SMI) (p = 0.006). No significant association was demonstrated between body composition variables, PFS and OS.
R-CHOP(like) treatment in DLBCL patients was associated with significant reduction of BMD, SMA and SMI.
主要目的是评估接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松 R-CHOP（类似）化疗方案治疗的弥漫性大 B 细胞淋巴瘤（DLBCL）患者的骨密度（BMD）变化。次要目的是评估其他身体成分特征的变化，并评估治疗前值及其随时间的变化与生存的相关性。
选择接受 R-CHOP（类似）方案治疗 DLBCL 的患者，并在治疗前后进行 PET-CT 检查。收集的主要临床数据包括体重指数、最后随访日期、进展日期和死亡日期。从低剂量 CT 图像中，在 L1 水平评估 BMD；使用专用软件，在 L3 水平评估其他身体成分值，包括肌肉和脂肪分布。描述性统计数据以中位数和四分位距或频率和百分比报告。使用 Wilcoxon 配对符号秩检验比较治疗前后身体成分变量的统计差异。使用 Shapiro-Wilk 检验测试变量的非正态分布。对于定性变量，使用 Fisher 确切检验。对数秩检验用于比较根据特定身体成分截止值定义的研究人群不同亚组之间的生存。显著性水平设置为 p < 0.05。
共纳入 82 例患者。平均随访时间为 37.5±21.4 个月。R-CHOP（类似）治疗前后平均 BMD 差异有统计学意义（p < 0.0001）。平均骨骼肌面积（SMA）（p = 0.004）和平均骨骼肌指数（SMI）（p = 0.006）也呈现相同趋势。身体成分变量与 PFS 和 OS 之间无显著相关性。
DLBCL 患者接受 R-CHOP（类似）治疗与 BMD、SMA 和 SMI 显著降低相关。
