Body Subcutaneous Fat Change Predicts Chemoradiotherapy Response and Prognosis of Esophageal Cancer Patients: A Cohort Study.

IF 2 4区医学 Q3 NUTRITION & DIETETICS

Nutrition and Cancer-An International Journal Pub Date : 2025-06-24 DOI:10.1080/01635581.2025.2519971

Hsueh-Chien Chiang, Ching-Juei Yang, Jing-Yao Wang, Forn-Chia Lin, Nai-Jung Chiang, Ta-Jung Chung, Yau-Lin Tseng, Bor-Shyang Sheu, Wei-Lun Chang

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引用次数: 0

Abstract

Background: Patients with esophageal cancer are prone to poor nutrition. Concurrent chemoradiation therapy (CCRT) may further influences body compositions including skeletal muscle (SM) and adipose tissue which are key indicators of nutritional status. This study aimed to evaluate whether body compositional change during CCRT could be a predictor of prognosis in esophageal cancer patients.

Methods: From 2006 to 2018, esophageal cancer patients who received CCRT as initial treatment were consecutively enrolled. We assessed body compositions, including subcutaneous fat (SCF), intramuscular fat (IMF), and SM mass by measuring the cross-sectional area (CSA) of the fourth thoracic vertebral body on computed tomography (CT) scan. The body compositional change was assessed by comparing baseline and post-CCRT CSA. The association of body compositions and their changes during CCRT with patient prognosis was analyzed.

Results: A total of 178 patients were enrolled with a mean baseline body mass index (BMI) of 22. After CCRT, there was a significant decrease in bodyweight (BW), SCF, IMF, and SM (P < 0.001). BMI and body compositions at baseline or post-CCRT were not significantly associated with patient prognosis. Patients with SCF loss during CCRT had significantly poorer CCRT response (OR 3.7, P < 0.001), shorter time to tumor progression (8.5 vs. 23.7 months, P = 0.011), and overall survival (13.7 vs. 25.9 months, P < 0.001) than patients with SCF gain/stable. IMF, SM, and BW change during CCRT did not correlate with CCRT response or survival. In multivariate Cox regression analysis, SCF change (HR 1.49, 95% CI: 1.03-2.14, P = 0.033) during CCRT was an independent predictor of survival after adjusting baseline BMI, cancer stage, treatment modality, and CCRT response.

Conclusions: During the course of CCRT, SCF change is more sensitive than weight in assessing the nutritional status of esophageal cancer patients. SCF loss during CCRT is associated with worse CCRT response and survival in esophageal cancer patients.

查看原文本刊更多论文

体表皮下脂肪变化预测食管癌患者放化疗反应和预后：一项队列研究。

背景：食管癌患者易出现营养不良。同步放化疗（CCRT）可能进一步影响身体成分，包括骨骼肌（SM）和脂肪组织，这是营养状况的关键指标。本研究旨在评估CCRT过程中身体成分的变化是否可以作为食管癌患者预后的预测因子。方法：2006 - 2018年，连续入组以CCRT为初始治疗的食管癌患者。我们通过计算机断层扫描（CT）测量第四胸椎体的横截面积（CSA）来评估身体组成，包括皮下脂肪（SCF）、肌内脂肪（IMF）和SM质量。通过比较基线和ccrt后的CSA来评估身体成分的变化。分析CCRT期间体成分及其变化与患者预后的关系。结果：共有178例患者入组，平均基线体重指数（BMI）为22。CCRT后，体重（BW）、SCF、IMF和SM显著下降（P P P = 0.011）， CCRT期间的总生存期（13.7个月vs 25.9个月，P P = 0.033）是调整基线BMI、癌症分期、治疗方式和CCRT反应后生存的独立预测因子。结论：在CCRT过程中，SCF变化对食管癌患者营养状况的评估比体重更敏感。食管癌患者CCRT期间SCF丢失与较差的CCRT反应和生存相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrition and Cancer-An International Journal 医学-营养学

CiteScore

5.80

自引率

3.40%

发文量

172

审稿时长

3 months

期刊介绍： This timely publication reports and reviews current findings on the effects of nutrition on the etiology, therapy, and prevention of cancer. Etiological issues include clinical and experimental research in nutrition, carcinogenesis, epidemiology, biochemistry, and molecular biology. Coverage of therapy focuses on research in clinical nutrition and oncology, dietetics, and bioengineering. Prevention approaches include public health recommendations, preventative medicine, behavior modification, education, functional foods, and agricultural and food production policies.