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接受奥希替尼治疗的非小细胞肺癌患者的营养状况及其对治疗耐受性的影响

Nutritional Status and Its Impact on Treatment Tolerance in Non-Small-Cell Lung Cancer Patients Receiving Osimertinib.

作者信息

Barca-Díez Claudia, Palmeiro-Carballa Regina, Castro-Luaces Susana, Fortes-González Maria Susana, Vazquez-Blanco Silvia, Martínez-López-De-Castro Noemi, Lago-Rivero Natividad

机构信息

Pharmacy Department, University Hospital Complex of Vigo, 36312 Vigo, Spain.

Pharmacy Department, University Hospital Complex of Pontevedra, 36071 Pontevedra, Spain.

出版信息

Nutrients. 2025 Mar 6;17(5):927. doi: 10.3390/nu17050927.

DOI:10.3390/nu17050927
PMID:40077797
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11901973/
Abstract

: Non-small-cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases and is a leading cause of morbidity and mortality worldwide. Between 35% and 65% of NSCLC patients experience nutritional problems or malnutrition, which significantly affects their prognosis and quality of life. This study aims to describe the nutritional status and body composition of NSCLC patients treated with osimertinib, an oral tyrosine kinase inhibitor, while also assessing the prevalence of sarcopenia, presarcopenia, and dynapenia. Additionally, we explore the relationship between dose-limiting toxicities (DLTs) and nutritional status, as well as the impact of nutritional status on quality of life using the EQ-5D scale. : A cross-sectional, observational study was conducted in 25 adult patients diagnosed with NSCLC treated with osimertinib under pharmacotherapeutic follow-up in the Pharmacy Consultations of a tertiary-level hospital. Anthropometric parameters, body composition (via bioimpedance analysis), and muscle functionality (via dynamometry) were assessed. Quality of life was evaluated using the EQ-5D scale. : The results showed that 36% of patients were malnourished, 4% had sarcopenia, 8% were presarcopenic, and 20% had dynapenia. Patients with DLTs exhibited significantly lower values of fat-free mass and the fat-free mass index, suggesting a relationship between low muscle mass and increased toxicities. : These findings underscore the importance of early, individualized nutritional interventions in NSCLC patients treated with osimertinib to improve nutritional status and optimize oncological outcomes. Further research with larger cohorts and longitudinal designs is necessary to confirm these findings.

摘要

非小细胞肺癌(NSCLC)约占所有肺癌病例的85%,是全球发病和死亡的主要原因。35%至65%的NSCLC患者存在营养问题或营养不良,这显著影响他们的预后和生活质量。本研究旨在描述接受口服酪氨酸激酶抑制剂奥希替尼治疗的NSCLC患者的营养状况和身体成分,同时评估肌肉减少症、肌肉减少症前期和肌肉功能减退的患病率。此外,我们探讨剂量限制性毒性(DLT)与营养状况之间的关系,以及使用EQ-5D量表评估营养状况对生活质量的影响。

在一家三级医院药房咨询处接受药物治疗随访的25例诊断为NSCLC并接受奥希替尼治疗的成年患者中进行了一项横断面观察性研究。评估了人体测量参数、身体成分(通过生物电阻抗分析)和肌肉功能(通过握力测量)。使用EQ-5D量表评估生活质量。

结果显示,36%的患者营养不良,4%患有肌肉减少症,8%处于肌肉减少症前期,20%存在肌肉功能减退。发生DLT的患者无脂肪量和无脂肪量指数的值显著较低,表明低肌肉量与毒性增加之间存在关联。

这些发现强调了对接受奥希替尼治疗的NSCLC患者进行早期个体化营养干预以改善营养状况和优化肿瘤学结局的重要性。需要进行更大样本量和纵向设计的进一步研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773f/11901973/387ca25f6ff5/nutrients-17-00927-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773f/11901973/387ca25f6ff5/nutrients-17-00927-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773f/11901973/387ca25f6ff5/nutrients-17-00927-g001.jpg

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