Hui Xu, Bin Zhang, Yongqian Zhang, Chunchun Yang, Changwen Bo, Yuanyuan Guo, Yuan Cheng, Li He
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引用次数: 0
Abstract
Background: The cachexia index (CXI) has been proposed as a novel biomarker of cancer cachexia. We aimed to investigate the association between CXI and survival outcomes after stereotactic radiotherapy (SRT) in patients with non-small cell lung cancer (NSCLC) and brain metastases.
Methods: Data from 145 patients with NSCLC, who underwent SRT for brain metastases between April 2016 and August 2020, were retrospectively analyzed. Cachexia index was calculated as skeletal muscle index (SMI) × serum albumin level/neutrophil-to-lymphocyte ratio, whereas SMI was calculated from computed tomography images captured at the L1 level. Kaplan-Meier curves and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS). The prognostic values of CXI and other cachexia biomarkers were assessed using receiver operating characteristic (ROC) curve analysis.
Results: Lower pretreatment CXI (<30.8) was significantly associated with older age (P = .039), lower Karnofsky performance score (P = .009), and a high likelihood of extracranial metastases (P = .001). Patients with a lower pretreatment CXI had a significantly shorter PFS and OS than those with a higher CXI (P < .001). Multivariate analysis revealed that pretreatment CXI was an independent risk factor for both PFS, hazard ratio (HR) = 2.375; 95% confidence interval (CI) = 1.610-3.504; P < .001, and OS, HR = 2.340; 95% CI = 1.562-3.505; P < .001. Compared with other biomarkers, pretreatment CXI had the highest area under the ROC curve value for prognostic assessment, reaching 0.734. Moreover, the loss of CXI was a strong risk factor for survival independent of pretreatment CXI (P = .011).
Conclusions: Cachexia index may serve as a clinically useful tool for predicting survival outcomes of patients with NSCLC and brain metastases who undergo SRT.
背景：恶病质指数（CXI）被认为是癌症恶病质的新型生物标志物。我们旨在研究CXI与非小细胞肺癌（NSCLC）脑转移患者立体定向放射治疗（SRT）后生存结果之间的关系：回顾性分析了2016年4月至2020年8月期间因脑转移接受立体定向放射治疗的145例NSCLC患者的数据。恶病质指数按骨骼肌指数（SMI）×血清白蛋白水平/中性粒细胞与淋巴细胞比率计算，而SMI则根据L1水平的计算机断层扫描图像计算。卡普兰-梅耶曲线和考克斯比例危险模型用于评估无进展生存期（PFS）和总生存期（OS）。使用接收器操作特征（ROC）曲线分析评估了CXI和其他恶病质生物标志物的预后价值：治疗前CXI较低（P = .039）、Karnofsky表现评分较低（P = .009）、颅外转移可能性较高（P = .001）。治疗前CXI较低的患者的PFS和OS明显短于CXI较高的患者（P P P P = .011）：痛觉缺失指数可作为预测接受SRT治疗的NSCLC脑转移患者生存预后的临床有用工具。
期刊介绍：
Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological topics. Of particular but not exclusive importance are molecular biology, clinical interventions, controlled trials, therapeutics, pharmacology and drug delivery, and techniques of cancer surgery. The journal welcomes unsolicited article proposals.
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