Endo Kazuhira, Ichinose Mariko, Kobayashi Eiji, Ueno Takayoshi, Hirai Nobuyuki, Nakanishi Yosuke, Kondo Satoru, Yoshizaki Tomokazu
Division of Otolaryngology, Head & Neck Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan.
Cancers (Basel). 2024 Oct 12;16(20):3460. doi: 10.3390/cancers16203460.
Sarcopenia is recognized as a crucial factor impacting the prognosis, treatment responses, and quality of life of HNC patients. This review discusses various mechanisms, including common etiological factors, such as aging, chronic inflammation, and metabolic dysregulation. Cancer-related factors, including tumor locations and treatment modalities, contribute to the development of sarcopenia. The clinical implications of sarcopenia in HNC patients extend beyond reduced muscle strength; it affects overall mobility, reduces quality of life, and increases the risk of falls and fractures. Sarcopenia serves as an independent predictor of postoperative complications, chemotherapy dose-limiting toxicity, and treatment outcomes, which affect therapy planning and perioperative management decisions. Methods to assess sarcopenia in HNC patients encompass various techniques. A sarcopenia assessment offers a potentially efficient and readily available tool for clinical practice. Interventions and management strategies for sarcopenia involve exercise interventions as a cornerstone; however, challenges arise due to patient-specific limitations during cancer treatment. A routine body composition analysis is proposed as a valuable addition to HNC patient management, with ongoing research required to refine preoperative exercise and nutrition programs for improved treatment outcomes and survival.
肌肉减少症被认为是影响头颈癌（HNC）患者预后、治疗反应和生活质量的关键因素。本综述讨论了各种机制，包括常见的病因，如衰老、慢性炎症和代谢失调。与癌症相关的因素，包括肿瘤位置和治疗方式，也促使了肌肉减少症的发展。肌肉减少症对HNC患者的临床影响不仅限于肌肉力量下降；它还会影响整体活动能力、降低生活质量，并增加跌倒和骨折的风险。肌肉减少症是术后并发症、化疗剂量限制性毒性和治疗结果的独立预测因素，这会影响治疗计划和围手术期管理决策。评估HNC患者肌肉减少症的方法包括多种技术。肌肉减少症评估为临床实践提供了一种潜在有效且易于获得的工具。针对肌肉减少症的干预和管理策略以运动干预为基石；然而，由于癌症治疗期间患者的个体局限性，仍存在挑战。建议将常规身体成分分析作为HNC患者管理的一项有价值的补充，还需要进行持续研究以完善术前运动和营养方案，从而改善治疗结果和生存率。
