Background: Malnutrition, loss of weight and of skeletal muscle mass are frequent in pancreatic cancer patients, a majority of which will undergo chemotherapy over the course of their disease. Available data suggest a negative prognostic role of these changes in body composition on disease outcomes; however, it is unclear whether tolerance to chemotherapeutic treatment is similarly and/or negatively affected. We aimed to explore this association by retrospectively assessing changes in body composition and chemotherapy-related toxicity in a cohort of advanced pancreatic cancer patients. Methods: Body composition was evaluated through clinical parameters and through radiological assessment of muscle mass, skeletal muscle area, skeletal muscle index and skeletal muscle density; and an assessment of fat distribution by subcutaneous adipose tissue and visceral adipose tissue. We performed descriptive statistics, pre/post chemotherapy comparisons and uni- and multivariate analyses to assess the relation between changes in body composition and toxicity. Results: Toxicity risk increased with an increase of skeletal muscle index (OR: 1.03) and body mass index (OR: 1.07), whereas it decreased with an increase in skeletal muscle density (OR: 0.96). Multivariate analyses confirmed a reduction in the risk of toxicity only with an increase in skeletal muscle density (OR: 0.96). Conclusions: This study suggests that the retrospective analysis of changes in body composition is unlikely to be useful to predict toxicity to gemcitabine—nab-paclitaxel.
背景：胰腺癌患者常伴有营养不良、体重减轻及骨骼肌质量下降，多数患者在病程中需接受化疗。现有数据表明，这些身体成分变化对疾病预后具有负面预测作用；然而，化疗耐受性是否同样受到负面影响尚不明确。本研究旨在通过回顾性评估晚期胰腺癌患者队列的身体成分变化与化疗相关毒性，探讨二者之间的关联。 方法：通过临床参数及影像学评估（包括肌肉质量、骨骼肌面积、骨骼肌指数和骨骼肌密度）评估身体成分，并通过皮下脂肪组织和内脏脂肪组织评估脂肪分布。采用描述性统计、化疗前后对比分析以及单因素与多因素分析方法，评估身体成分变化与毒性之间的关联。 结果：毒性风险随骨骼肌指数（比值比：1.03）和体重指数（比值比：1.07）的增加而升高，而随骨骼肌密度增加（比值比：0.96）而降低。多因素分析证实，仅骨骼肌密度增加与毒性风险降低相关（比值比：0.96）。 结论：本研究表明，回顾性分析身体成分变化可能无法有效预测吉西他滨-白蛋白结合型紫杉醇方案的化疗毒性。
肿瘤(癌症)患者之家