Qu Jiaoyue, Liu Yang, Yuan Yin, Yu Zhao, Ding Jianming, He Zelai, Wang Gengming
Department of Oncology and Radiotherapy, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Front Nutr. 2025 Feb 20;12:1523674. doi: 10.3389/fnut.2025.1523674. eCollection 2025.
Sarcopenia is a common indicator of systemic nutritional status in patients with cancer progression. This study investigated the impacts of sarcopenia on adverse effects and prognosis of sarcopenia on patients with esophageal cancer receiving chemoradiotherapy.
The clinical data of 158 patients with initially diagnosed esophageal cancer who received chemoradiotherapy were collected, and nutritional indexes and inflammatory markers were calculated. The cross-sectional areas of the skeletal muscle, subcutaneous fat and visceral fat were calculated using computed tomography (CT) images of the midpoint of the third lumbar (L3) vertebra. The incidence of adverse events, response evaluation, 1-year and 3-year overall survival (OS) and progression-free survival (PFS) were compared between sarcopenia group and non-sarcopenia groups.
This study included 158 patients, 103 (71.5%) in the sarcopenia group and 45 (28.5%) in the non-sarcopenia group. The last follow-up date was January 31, 2024. The median follow-up time was 36 months for all patients. The chi-square test revealed no significant difference in the incidence of serious adverse events between the two groups. The complete response rates (CR) of patients in the sarcopenia and non-sarcopenia groups 1 month after chemoradiotherapy were 2.7 and 13.3%, respectively, = 0.017, and the difference was statistically significant. Moreover, the objective response rates (ORR) were 38.9 and 60.0%, respectively (χ = 5.770, = 0.016). The median survival time for all patients was 36 months [95% Confidence Interval CI 24-48]. Univariate analysis (Cox proportional risk model) showed that sarcopenia, KPS score, albumin level, T stage, and N stage were correlated with patients' OS. Multivariate analysis showed that sarcopenia (Hazard Ratio HR 2.84, 95%CI [1.45-5.57], = 0.002), KPS score, albumin level and N stage were independent prognostic factors for OS.
Sarcopenia reduced OS in patients with EC treated with chemoradiotherapy. It can be used as an independent indicator to predict the OS of such patients, which may help in developing optimal treatment strategies.
肌肉减少症是癌症进展患者全身营养状况的常见指标。本研究调查了肌肉减少症对接受放化疗的食管癌患者不良反应和预后的影响。
收集158例初诊食管癌且接受放化疗患者的临床资料，计算营养指标和炎症标志物。使用第三腰椎（L3）中点的计算机断层扫描（CT）图像计算骨骼肌、皮下脂肪和内脏脂肪的横截面积。比较肌肉减少症组和非肌肉减少症组不良事件的发生率、疗效评估、1年和3年总生存（OS）率及无进展生存（PFS）率。
本研究纳入158例患者，肌肉减少症组103例（71.5%），非肌肉减少症组45例（28.5%）。最后随访日期为2024年1月31日。所有患者的中位随访时间为36个月。卡方检验显示两组严重不良事件发生率无显著差异。放化疗1个月后，肌肉减少症组和非肌肉减少症组患者的完全缓解率（CR）分别为2.7%和13.3%，P = 0.017，差异有统计学意义。此外，客观缓解率（ORR）分别为38.9%和60.0%（χ² = 5.770，P = 0.016）。所有患者的中位生存时间为36个月[95%置信区间CI 24 - 48]。单因素分析（Cox比例风险模型）显示，肌肉减少症、KPS评分、白蛋白水平、T分期和N分期与患者的OS相关。多因素分析显示，肌肉减少症（风险比HR 2.84，95%CI [1.45 - 5.57]，P = 0.002）、KPS评分、白蛋白水平和N分期是OS的独立预后因素。
肌肉减少症降低了接受放化疗的食管癌患者的OS。它可作为预测此类患者OS的独立指标，这可能有助于制定最佳治疗策略。
