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肌少症对接受抗血管生成治疗的晚期非小细胞肺癌患者预后的影响:倾向评分匹配分析。

Impact of sarcopenia on the prognosis of patients with advanced non-small cell lung cancer treated with antiangiogenic therapy: A propensity score matching analysis.

机构信息

Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China.

出版信息

Thorac Cancer. 2024 Nov;15(31):2248-2259. doi: 10.1111/1759-7714.15443. Epub 2024 Sep 22.

Abstract

BACKGROUND

Limited information is available regarding the impact of sarcopenia on the prognosis of antiangiogenic therapy in individuals with advanced non-small cell lung cancer (NSCLC). This study primarily sought to examine the prognostic significance of sarcopenia in individuals with advanced NSCLC undergoing antiangiogenic therapy.

METHODS

We retrospectively enrolled all patients who met the inclusion and exclusion criteria from 2019 to 2021 at Nantong University Hospital. Patients were grouped according to the presence or absence of sarcopenia. After propensity score matching (PSM), progression-free survival (PFS), overall survival (OS), and adverse event rates were compared between the two groups. Factors associated with prognosis were screened using univariate and multivariate analyses.

RESULTS

A total of 267 patients were included, with a total of 201 matched at baseline after PSM (77 in the sarcopenia group and 124 in the non-sarcopenia group). The sarcopenia group had lower PFS (p = 0.043) and OS (p = 0.011) than the non-sarcopenia group and a higher incidence of adverse events (p = 0.044). Multivariate analysis suggested that sarcopenia is an independent prognostic risk factor for OS in advanced NSCLC patients receiving antiangiogenic therapies (p = 0.009). Results of subgroup analyses showed some differences in the impact of sarcopenia on survival prognosis in populations with different characteristics.

CONCLUSION

Patients with advanced NSCLC with comorbid sarcopenia exhibit a worse prognosis when treated with antiangiogenic therapy, and preventing and ameliorating sarcopenia may lead to better survival outcomes in patients with advanced NSCLC.

摘要

背景

关于肌少症对晚期非小细胞肺癌(NSCLC)患者接受抗血管生成治疗预后的影响,相关信息有限。本研究主要旨在探讨肌少症对接受抗血管生成治疗的晚期 NSCLC 患者预后的预测价值。

方法

我们回顾性纳入了 2019 年至 2021 年南通大学附属医院符合纳入和排除标准的所有患者。根据是否存在肌少症将患者分组。进行倾向评分匹配(PSM)后,比较两组患者的无进展生存期(PFS)、总生存期(OS)和不良事件发生率。采用单因素和多因素分析筛选与预后相关的因素。

结果

共纳入 267 例患者,PSM 后共有 201 例基线匹配(肌少症组 77 例,非肌少症组 124 例)。肌少症组的 PFS(p=0.043)和 OS(p=0.011)均短于非肌少症组,且不良事件发生率较高(p=0.044)。多因素分析表明,肌少症是接受抗血管生成治疗的晚期 NSCLC 患者 OS 的独立预后危险因素(p=0.009)。亚组分析结果显示,肌少症对不同特征人群生存预后的影响存在差异。

结论

伴合并症肌少症的晚期 NSCLC 患者接受抗血管生成治疗的预后较差,预防和改善肌少症可能会改善晚期 NSCLC 患者的生存结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63fe/11543275/8047893c9e92/TCA-15-2248-g002.jpg

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