| 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].Chinese Journal of Radiological Medicine and Protection,2024,44(6):497-503 |
| Impact of sarcopenia on short-term outcomes and long-term prognosis in cervical cancer patients undergoing concurrent chemoradiotherapy |
| Received:October 11, 2023 |
| DOI：10.3760/cma.j.cn112271-20231011-00117 |
| KeyWords:Cervical cancer Sarcopenia Radiotherapy Chemotherapy Prognosis |
| FundProject:河南省医学科技攻关联合共建项目(LHGJ20220057) |
| Author Name | Affiliation | E-mail | | Liu Mingbo | Department of Cancer Center, Henan Provincial People's Hospital, Zhengzhou 450000, China | | | Dong Qingqing | Department of Cancer Center, Henan Provincial People's Hospital, Zhengzhou 450000, China | | | Zhou Bo | Department of Cancer Center, Henan Provincial People's Hospital, Zhengzhou 450000, China | | | Liu Dongbin | Department of Cancer Center, Henan Provincial People's Hospital, Zhengzhou 450000, China | | | Wang Yuewei | Department of Cancer Center, Henan Provincial People's Hospital, Zhengzhou 450000, China | | | Wu Guangyin | Department of Cancer Center, Henan Provincial People's Hospital, Zhengzhou 450000, China | wuguangyin120@126.com |
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| Abstract:: |
| 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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