Liu Penghui, Li Na, Wang Jizhen, Guo Lingyun, Guo Jiwu, Shi Guoqing, Mao Jie
Lanzhou University Second Clinical Medical College, Lanzhou, China.
Lanzhou University Second Hospital, The Medical Department, Lanzhou, China.
Front Oncol. 2025 Aug 19;15:1601819. doi: 10.3389/fonc.2025.1601819. eCollection 2025.
This study aimed. to explore the predictive value of body composition changes in the efficacy of neoadjuvant cadonilimab combined with FLOT therapy for advanced gastric cancer and provide a reference for personalized treatment.
A retrospective study was conducted on 33 patients with advanced gastric cancer who received neoadjuvant cadonilimab combined with FLOT therapy and subsequently underwent surgery. Body composition data were obtained using the InBody 720 body composition analysis device. Based on treatment response, patients were classified into the objective response group and the no-progression group. Quantitative data were presented as median and interquartile range. The Mann-Whitney U test was used for intergroup comparisons, analyzing the relationship between body composition changes before and after neoadjuvant therapy and treatment outcomes.
The changes in LBM, SLM, SMM, VFA, LEFT ARM SLM, RIGHT ARM SLM, LEFT LEG SLM, RIGHT LEG SLM, TRUNK SLM and IMPEDANCE before and after neoadjuvant therapy showed significant differences (P < 0.05) between two groups, indicating statistical significance. LBM, SLM and SMM showed a decreasing trend in both groups and the reduction was greater in the no-progression group than in the objective response group; VFA expressed a significant reduction in the objective response group, but it tended to increase in the no-progression group; IMPEDANCE showed a significant increase in the objective response group, but the change was insignificant in the no-progression group. SLM in the trunk and limbs showed a decreasing trend in both groups and the reduction was greater in the no-progression group than in the objective response group. The changes in HEIGHT, WEIGHT, BFM, PBF, LEFT ARM MBF, RIGHT ARM MBF, LEFT LEG MBF, RIGHT LEG MBF, TRUNK MBF, WHR and WAIST showed no significant differences (P ≥ 0.05) between two groups, indicating they were not statistically significant.
The changes in LBM, SLM, SMM, VFA and IMPEDANCE can predict the efficacy of neoadjuvant cadonilimab plus FLOT therapy in advanced gastric cancer, especially LBM, SLM and SMM show the highest predictive value. Variations in SLM across different anatomical sites have distinct effects on treatment outcomes, the trunk has the most significant impact, followed by the lower limbs and the upper limbs have the least effect.
www.chictr.org.cn, identifier ChiCTR2200066893.
本研究旨在探讨身体成分变化对晚期胃癌新辅助卡度尼利单抗联合FLOT方案治疗疗效的预测价值，为个性化治疗提供参考。
对33例接受新辅助卡度尼利单抗联合FLOT方案治疗并随后接受手术的晚期胃癌患者进行回顾性研究。使用InBody 720人体成分分析仪获取身体成分数据。根据治疗反应，将患者分为客观缓解组和无进展组。定量数据以中位数和四分位数间距表示。采用Mann-Whitney U检验进行组间比较，分析新辅助治疗前后身体成分变化与治疗结果之间的关系。
新辅助治疗前后两组间瘦体重（LBM）、骨骼肌量（SLM）、体细胞质量（SMM）、内脏脂肪面积（VFA）、左臂骨骼肌量、右臂骨骼肌量、左腿骨骼肌量、右腿骨骼肌量、躯干骨骼肌量和阻抗的变化差异有统计学意义（P<0.05）。两组的LBM、SLM和SMM均呈下降趋势，且无进展组的下降幅度大于客观缓解组；客观缓解组的VFA显著降低，而无进展组则呈上升趋势；客观缓解组的阻抗显著增加，而无进展组的变化不显著。两组躯干和四肢的SLM均呈下降趋势，且无进展组的下降幅度大于客观缓解组。两组间身高、体重、体脂量、体脂百分比、左臂肌肉量、右臂肌肉量、左腿肌肉量、右腿肌肉量、躯干肌肉量、腰臀比和腰围的变化差异无统计学意义（P≥0.05）。
LBM、SLM、SMM、VFA和阻抗的变化可预测新辅助卡度尼利单抗联合FLOT方案治疗晚期胃癌的疗效，尤其是LBM、SLM和SMM的预测价值最高。不同解剖部位的SLM变化对治疗结果有不同影响，躯干影响最显著，其次是下肢，上肢影响最小。
