| 刘明博,董青青,周博,等.肌少症对同步放化疗宫颈癌患者近期效果和远期预后的影响[J].中华放射医学与防护杂志,2024,44(6):497-503.Liu Mingbo,Dong Qingqing,Zhou Bo,et al.Impact of sarcopenia on short-term outcomes and long-term prognosis in cervical cancer patients undergoing concurrent chemoradiotherapy[J].Chin J Radiol Med Prot,2024,44(6):497-503 |
| 肌少症对同步放化疗宫颈癌患者近期效果和远期预后的影响 |
| Impact of sarcopenia on short-term outcomes and long-term prognosis in cervical cancer patients undergoing concurrent chemoradiotherapy |
| 投稿时间：2023-10-11 |
| DOI：10.3760/cma.j.cn112271-20231011-00117 |
| 中文关键词: 宫颈癌 肌少症 放射治疗 化学治疗 预后 |
| 英文关键词:Cervical cancer Sarcopenia Radiotherapy Chemotherapy Prognosis |
| 基金项目:河南省医学科技攻关联合共建项目(LHGJ20220057) |
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| 中文摘要: |
| 目的 探讨肌少症对同步放化疗(CCRT)宫颈癌患者近期效果和远期预后的影响。方法 前瞻性选取2017年1月至2021年12月在河南省人民医院治疗的410例行CCRT治疗的宫颈癌患者为研究对象,应用生物电阻抗方法测量体内肌肉含量,并据此分为肌少症组和非肌少症组。按照实体瘤疗效评价标准评估近期疗效,按美国放射治疗协作组分级标准评价急性不良反应。记录因各种急性不良反应而导致CCRT终止或治疗时间延长情况。所有患者进行随访,观察终点为总生存期(OS)和无复发生存期(PFS),估算生存率,分析肌少症和PFS的关系。结果 152例(37.1%)患者有肌少症。与非肌少症组相比,肌少症组的2级以上下消化道和血液系统急性不良反应、CCRT终止或治疗时间延长比例均高于非肌少症组。非肌少症组有27例死亡,其OS为30(18~36)个月,3年生存率为88.7%,5年生存率为85.6%;肌少症组有23例死亡,其OS为24(15~33)个月,3年生存率为83.8%,5年生存率为77.7%。2组之间生存曲线差异无统计学意义(P＞0.05)。非肌少症组有52例复发,其PFS为21(12~33)个月,3年无复发生存率为77.9%,5年无复发生存率为71.0%;肌少症组有41例复发,其PFS为15(10.5~24)个月,3年无复发生存率为69.0%,5年无复发生存率为56.5%。2组之间无复发生存曲线差异有统计学意义(χ2=5.89,P=0.015)。多因素Cox回归分析,肌少症是PFS的独立危险因素(χ2=4.33,P=0.037)。结论 肌少症增加了行CCRT治疗的宫颈癌患者的急性不良反应和远期复发风险。 |
| 英文摘要: |
| Objective To investigate the impact of sarcopenia on the short-term outcomes and long-term prognosis in cervical cancer patients undergoing concurrent chemoradiotherapy (CCRT). Methods A total of 410 cervical cancer patients who received CCRT in Henan Provincial People's Hospital between January 2017 and December 2021 were prospectively enrolled in this study. They were divided into the sarcopenia and non-sarcopenia groups based on the body muscle content measured using bioelectrical impedance analysis. Short-term outcomes were assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST), and acute adverse reactions were assessed based on the toxicity criteria of the Radiation Therapy Oncology Group (RTOG). CCRT termination or prolonged treatment associated with various acute adverse reactions were recorded. All patients were followed up with overall survival (OS) and progression-free survival (PFS) as endpoints. Finally, the survival rate was estimated and the association between sarcopenia and PFS was analyzed. Results Among the patients, 152 (37. 1%) had sarcopenia. Compared to the non-sarcopenia group, the sarcopenia group exhibited higher incidences of grade 2 or above acute adverse reactions in the lower gastrointestinal and hematological systems, CCRT termination, or prolonged treatment. In the non-sarcopenia group, 27 deaths were recorded, with an OS of 30 (18-36) months, a 3-year OS rate of 88. 7%, and a 5-year OS rate of 85. 6%. In the sarcopenia group, 23 deaths were found, with an OS of 24 (15-33) months, a 3-year OS rate of 83. 8%, and a 5-year OS rate of 77. 7%. There was no significant difference in survival curves between both groups (P ＞ 0. 05). In the non-sarcopenia group, 52 cases of recurrence were recorded, with a PFS of 21 (12-33) months, a 3-year PFS rate of 77. 9%, and a 5-year PFS rate of 71. 0%. In the sarcopenia group, 41 cases of recurrence were found, with a PFS of 15 (10. 5-24) months, a 3-year PFS rate of 69. 0%, and a 5-year PFS rate of 56. 5%. There was a significant difference in the PFS curves between both groups (χ2 = 5. 89, P = 0. 015). Multivariate Cox regression analysis identified sarcopenia as an independent risk factor for PFS (χ2 =4. 33, P = 0. 037). Conclusions Sarcopenia increases the risks of acute adverse reactions and long-term recurrence in cervical cancer patients undergoing CCRT. |
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