Relationship Between Sarcopenia and Prognosis in Patient With Concurrent Chemo-Radiation Therapy for Esophageal Cancer

Frontiers in Oncology

卷:9

Ik Jae Lee²  Jun Won Kim²  Mi-jin Jeon²  Yeona Cho²  Da Hyun Jung³  Young Hoon Youn³  Hei Cheul Jeung³  Hyojin Park³  Dae Won Ma³  Jie-Hyun Kim³  Jae Jun Park³  Chang Geol Lee⁴ 

[1] Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea;

[2] Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea;

[3] Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;

[4] Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;

关键词: esophageal cancer;    concurrent chemo- and radiotherapy;    sarcopenia;    prognosis;    complication;   

DOI  :  10.3389/fonc.2019.00366

来源: DOAJ

【 摘 要 】

Background: Sarcopenia, defined as skeletal muscle loss, has been known as a poor prognosis factor in various malignant diseases The aim of this study is to investigate the effect of sarcopenia on prognosis in patients with esophageal cancer who received concurrent chemo- and radiotherapy (CCRT).Methods: We retrospectively collected clinical data of 287 patients with esophageal cancer who were treated by definite CCRT at Gangnam Severance and Severance hospital from August 2005 to December 2014. The cross-sectional area of muscle at the level of the third lumbar vertebra was measured using pre- and post-CCRT computed tomography images. Sarcopenia was defined as skeletal muscle index <49 cm2/m2 for men and of <31 cm2/m2 for women by Korean-specific cutoffs. Overall survival (OS) and progression free survival (PFS) were analyzed according to sarcopenia.Results: Sarcopenia identified before CCRT did not affect OS and PFS. However, patients with post-CCRT sarcopenia showed shorter OS and PFS than patients without it (median OS: 73 months vs. 28 months; median PFS: 34 months vs. 25 months, respectively). Post-CCRT sarcopenia was an independent prognostic factor of poor OS (hazards ratio: 1.697; 95% confidence interval: 1.036–2.780; P = 0.036). In multivariate analysis, male sex (P = 0.004) and presence of CCRT-related complications, such as esophagitis or general weakness were significantly associated with post-CCRT sarcopenia (P = 0.016).Conclusions: Sarcopenia after CCRT can be a useful predictor for long-term prognosis in patients with esophageal cancer. To control CCRT-related complications may be important to prevent skeletal muscle loss during CCRT.

【 授权许可】

Unknown