Department of Radiation Oncology, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Guangxi Key Laboratory of High-Incidence-Tumor Prevention and Treatment, Ministry of Education, Guangxi Medical University, Nanning, China.
Jpn J Radiol. 2024 Sep;42(9):1047-1057. doi: 10.1007/s11604-024-01587-3. Epub 2024 May 10.
Sarcopenia, characterized by loss of muscle mass index (SMI), serves as a diagnostic indicator for malnutrition and has been shown to influence cancer treatment outcomes. The objective of this study was to investigate the prognostic significance of sarcopenia on the locally advanced nasopharyngeal carcinoma (laNPC) patients.
545 patients with stage III-IVa NPC were included in this retrospective study. Sarcopenia was defined using the skeletal muscle index (SMI) determined at the C3 level based on baseline MRI. The log-rank test and the Cox proportional hazards model were used to compare overall survival (OS) and progression-free survival (PFS).
The results of the multivariate analysis revealed that sarcopenia group (HR = 2.82, 95% CI 1.96-4.06, P < 0.01), T4 stage (HR = 1.64, 95% CI 1.24-2.15, P < 0.01), N3 stage (HR = 1.91, 95% CI 1.52-2.40, P < 0.01), comorbidities (HR = 2.08, 95% CI 1.45-2.97, P < 0.01), and any adverse event grade 3-4 (HR = 1.48, 95% CI 1.04-2.01, P = 0.03) were identified as independent risk factors that significantly impacted the OS. Additionally, sarcopenia group (HR = 2.40, 95% CI 1.73-3.33, P < 0.01), T4 stage (HR = 1.50, 95% CI 1.17-1.92, P < 0.01), N3 stage (HR = 1.80, 95% CI 1.46-2.22, P < 0.01), sarcopenia group (HR = 2.40, 95% CI 1.73-3.33, P < 0.01), and any adverse event grade 3-4 (HR = 1.45, 95% CI 1.04-2.01, P = 0.03) were found to have a significant impact on PFS.
Sarcopenia was identified as a prognostic factor for patients with laNPC. Furthermore, T stage, N stage, comorbidities, and any adverse event grade 3-4 were identified as independent prognostic factors for laNPC.
肌少症的特征是肌肉质量指数（SMI）下降，可作为营养不良的诊断指标，并已被证明会影响癌症治疗结果。本研究的目的是探讨肌少症对局部晚期鼻咽癌（laNPC）患者的预后意义。
本回顾性研究纳入了 545 例 III-IVa 期 NPC 患者。肌少症使用基线 MRI 确定的 C3 水平的骨骼肌指数（SMI）定义。采用对数秩检验和 Cox 比例风险模型比较总生存期（OS）和无进展生存期（PFS）。
多因素分析结果显示，肌少症组（HR=2.82，95%CI 1.96-4.06，P<0.01）、T4 期（HR=1.64，95%CI 1.24-2.15，P<0.01）、N3 期（HR=1.91，95%CI 1.52-2.40，P<0.01）、合并症（HR=2.08，95%CI 1.45-2.97，P<0.01）和任何 3-4 级不良事件（HR=1.48，95%CI 1.04-2.01，P=0.03）被确定为显著影响 OS 的独立危险因素。此外，肌少症组（HR=2.40，95%CI 1.73-3.33，P<0.01）、T4 期（HR=1.50，95%CI 1.17-1.92，P<0.01）、N3 期（HR=1.80，95%CI 1.46-2.22，P<0.01）、肌少症组（HR=2.40，95%CI 1.73-3.33，P<0.01）和任何 3-4 级不良事件（HR=1.45，95%CI 1.04-2.01，P=0.03）均对 PFS 有显著影响。
肌少症被确定为 laNPC 患者的预后因素。此外，T 分期、N 分期、合并症和任何 3-4 级不良事件被确定为 laNPC 的独立预后因素。
