Holtorf Christian, Mengoni Miriam, Tüting Thomas, Wienke Andreas, Borggrefe Jan, Surov Alexey, Alter Mareike
Hautarztpraxis Dr. med. Anke Raschke, Magdeburg, Deutschland.
Universitätsklinik für Dermatologie und Venerologie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland.
Dermatologie (Heidelb). 2024 Oct;75(10):798-803. doi: 10.1007/s00105-024-05405-9. Epub 2024 Aug 14.
Sarcopenia is the generalized loss of muscle strength, mass, and function. The aim was to investigate whether pretherapeutic sarcopenia, as determined by the psoas muscles, affects therapy-mediated toxicity in patients with malignant melanoma undergoing immunotherapy.
Measurement of psoas musculature was performed pretherapeutically using computed tomography at the level of the third lumbar vertebra in the axial plane in 75 patients between January 2011 and December 2020. Sarcopenia was defined using the psoas muscle index (PMI). Immune-related toxicity was retrospectively assessed.
Treatment-related toxicity was recorded in 33 of the 75 patients (44%). Of these, 16 patients (36.2%) experienced dose-limiting severe events (DLT). Pretherapeutic sarcopenia was identified in 25 patients (33.3%). Comparative analysis showed that the patients with a DLT had lower PMI values compared with the patient group without a DLT (4.65 ± 1.33 vs. 5.79 ± 1.67 cmm, p = 0.015) (odds ratio = 0.60, 95% confidence interval 0.40-0.92, p = 0.02).
Pretherapeutic sarcopenia measured based on the psoas muscle is not a significant predictor of immune-mediated toxicity in patients with malignant melanoma treated with immune checkpoint inhibitors. Patients with DLT have lower values for the psoas muscle parameters PMI compared to the group of patients without DLT.
肌肉减少症是肌肉力量、质量和功能的全身性丧失。本研究旨在调查由腰大肌确定的治疗前肌肉减少症是否会影响接受免疫治疗的恶性黑色素瘤患者的治疗介导毒性。
2011年1月至2020年12月期间，对75例患者在第三腰椎水平进行轴向平面的计算机断层扫描，在治疗前测量腰大肌组织。使用腰大肌指数（PMI）定义肌肉减少症。对免疫相关毒性进行回顾性评估。
75例患者中有33例（44%）记录到治疗相关毒性。其中，16例患者（36.2%）经历了剂量限制性严重事件（DLT）。25例患者（33.3%）被确定为治疗前存在肌肉减少症。比较分析显示，与无DLT的患者组相比，发生DLT的患者PMI值较低（4.65±1.33 vs. 5.79±1.67 cmm，p = 0.015）（优势比 = 0.60，95%置信区间0.40 - 0.92，p = 0.02）。
基于腰大肌测量的治疗前肌肉减少症不是接受免疫检查点抑制剂治疗的恶性黑色素瘤患者免疫介导毒性的显著预测指标。与无DLT的患者组相比，发生DLT的患者腰大肌参数PMI值较低。
