肿瘤防治研究2023，Vol.50Issue(12)：1203-1208,6.DOI:10.3971/j.issn.1000-8578.2023.23.0540
食管鳞癌患者同步放化疗前骨骼肌量减少与放化疗急性不良反应的研究
Sarcopenia Before Concurrent Chemoradiotherapy May Develop Severe Adverse Reactions in Patients with Esophageal Squamous Cell Carcinoma
摘要
Abstract
Objective To investigate whether sarcopenia before concurrent chemoradiotherapy is prone to grade≥3 acute adverse reactions(AAR)and shorten survival in patients with advanced esophageal squamous cell carcinoma(ESCC).Methods Data of advanced patients with pathologically diagnosed ESCC and CCRT(FP regimen)from August 2018 to July 2022 were reviewed retrospectively.Skeletal muscle mass and body composition were measured using pre-treatment CT images,and patients were divided into sarcopenia and non-sarcopenia groups.Grade ≥3 AAR was diagnosed based on CTCAE5.0 and acute radiation injury criteria of the US RTOG.Risk factors for developing grade ≥ 3 AAR were analyzed,and survival rates were calculated by Kaplan-Meier method.Results Among 132 patients with ESCC(87 in the sarcopenia group and 45 in the non-sarcopenia group),23(17.4％)experienced grade ≥3 AAR.In multivariate regression analysis,independent risk factors for grade ≥3 AAR included the following:sarcopenia(OR:6.034,95％CI:1.206-30.190,P=0.029),decreased SMD(OR:0.693,95％CI:0.492-0.976,P=0.036),decreased SMI(OR:0.841,95％CI:0.721-0.982,P=0.028),and increased FMI(OR:2.433,95％CI:1.194-4.958;P=0.014).The OS rates were 16.01 months(95％CI:14.89-17.13)in the sarcopenia group and 19.27 months(95％CI:14.45-24.09)in the non-sarcopenia group(x2=5.326,P=0.021)as well as 14.86 months(95％CI:11.30-18.42)for patients with grade≥3 AAR and 16.67 months(95％CI:14.91-18.43)for patients with grade 0-2 AAR(x2=5.47,P=0.019).Among patients with grade≥3 AAR,the OS rates were 12.13 months(95％CI:10.15-14.11)in the sarcopenia group and 18.69 months(95％CI:12.85-21.88)in the non-sarcopenia group(x2=4.466,P=0.035).Conclusion Sarcopenia,decreased skeletal muscle density,and increased fat mass are important predictors of grade ≥3 AAR.The OS of patients with sarcopenia and grade ≥ 3 AAR may be reduced.关键词
食管鳞状细胞癌/身体组成成分/肌肉减少症/放化疗/急性不良反应Key words
Esophageal squamous cell carcinoma/Body composition/Sarcopenia/Chemoradiotherapy/Acute adverse reaction分类
医药卫生引用本文复制引用
陈晓霞,王飞,刘彩云,李晓峰,拾博,王强..食管鳞癌患者同步放化疗前骨骼肌量减少与放化疗急性不良反应的研究[J].肿瘤防治研究,2023,50(12):1203-1208,6.基金项目
Key Research and Development Project by Xuzhou Science and Technology Bureau(No.KC18200) （No.KC18200）
Project by Jiangsu University(No.JLY20180119)徐州市科技局重点研发课题(KC18200) （No.JLY20180119）
江苏大学课题(JLY20180119) （JLY20180119）
