Oyama Yuki, Akezaki Yoshiteru, Kakuta Takeshi, Sugiura Mizuki, Fukumura Yoshiko, Okuma Keiko, Maeda Takeshi, Kakehi Shingo, Saito Takashi, Goto Miori, Ikeda Hiroyoshi, Mukaiyama Taketo, Yoshizawa Akitaka
Department of Rehabilitation Medicine, Kanamecho Hospital, Tokyo, Japan.
Division of Physical Therapy, Kochi Professional University of Rehabilitation, Kochi, Japan.
Prog Rehabil Med. 2024 Oct 2;9:20240031. doi: 10.2490/prm.20240031. eCollection 2024.
Cancer cachexia has many effects on physical function and causes a decline in activities of daily living (ADL). Therefore, rehabilitation programs should be structured according to the degree of cancer cachexia. Currently, the evaluation of cancer cachexia is mainly based on body mass. However, there is no report on the use of the modified Glasgow Prognostic Score (mGPS) to evaluate the degree of cancer cachexia and survival prognosis in palliative cancer patients for whom rehabilitation has been prescribed. This study used mGPS to examine the prevalence of cancer cachexia in palliative cancer patients undergoing rehabilitation and the impacts of cancer cachexia, ADL, and complications on survival.
The participants included 135 palliative cancer patients who were admitted to the hospital and underwent rehabilitation between 2020 and 2022. Cancer cachexia classification by mGPS was conducted, and logistic regression analysis was used to examine factors affecting the survival of palliative cancer patients undergoing rehabilitation.
The patients were grouped as follows: 6 (4.4%) normal, 13 (9.6%) undernourished, 12 (9.0%) pre-cachexia, and 104 (77.0%) refractory cachexia. Logistic regression analysis showed that the mGPS and BI affected survival.
In a cohort of palliative cancer patients undergoing rehabilitation, 86% had cachexia. mGPS and BI were associated with survival outcomes. Combination of mGPS classification with ADL assessment may provide meaningful prognostic information in these patients.
癌症恶病质对身体功能有诸多影响,并导致日常生活活动能力(ADL)下降。因此,康复计划应根据癌症恶病质的程度来制定。目前,癌症恶病质的评估主要基于体重。然而,尚无关于使用改良格拉斯哥预后评分(mGPS)来评估已开具康复处方的姑息性癌症患者的癌症恶病质程度和生存预后的报道。本研究使用mGPS来研究接受康复治疗的姑息性癌症患者中癌症恶病质的患病率,以及癌症恶病质、ADL和并发症对生存的影响。
研究对象包括2020年至2022年间入院并接受康复治疗的135例姑息性癌症患者。采用mGPS进行癌症恶病质分类,并使用逻辑回归分析来研究影响接受康复治疗的姑息性癌症患者生存的因素。
患者分组如下:6例(4.4%)正常,13例(9.6%)营养不良,12例(9.0%)恶病质前期,104例(77.0%)难治性恶病质。逻辑回归分析显示mGPS和巴氏指数(BI)影响生存。
在一组接受康复治疗的姑息性癌症患者中,86%患有恶病质。mGPS和BI与生存结果相关。mGPS分类与ADL评估相结合可能为这些患者提供有意义的预后信息。