预处理生物电阻抗分析预测转移性结直肠癌患者化疗的疗效和毒性。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-22 DOI:10.1016/j.clnesp.2025.02.015

Rikako Kato , Yuji Miyamoto , Yukiharu Hiyoshi , Yuto Maeda , Mayuko Ouchi , Katsuhiro Ogawa , Keisuke Kosumi , Kojiro Eto , Satoshi Ida , Masaaki Iwatsuki , Yoshifumi Baba , Hideo Baba

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引用次数: 0

摘要

背景：体成分在接受全身化疗的转移性结直肠癌（mCRC）患者中的预后意义日益被认识。本研究旨在探讨利用生物电阻抗分析（BIA）测量的各种身体成分指标与mCRC患者预后之间的关系。方法：在164例mCRC患者的回顾性队列中，在一线化疗前使用BIA评估体成分。评估的指标包括细胞外水/全身水比（ECW/TBW）、骨骼肌质量、体脂肪质量、蛋白质和矿物质水平。本研究探讨了这些参数与生存结果之间的关系，以及它们对化疗毒性和相对剂量强度的影响。结果：ECW/TBW比值较高的患者总生存期（OS）显著降低(p结论：本研究强调了BIA综合体成分评估在预测mCRC患者预后方面的价值，支持将其纳入临床实践，以加强患者护理。

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Pretreatment bioelectrical impedance analysis predicts chemotherapy efficacy and toxicity in metastatic colorectal cancer patients

Background

The prognostic significance of body composition in metastatic colorectal cancer (mCRC) patients receiving systemic chemotherapy is increasingly recognized. This study aimed to explore the relationship between various body composition metrics measured using bioelectrical impedance analysis (BIA) and patient outcomes in patients with mCRC.

Methods

In a retrospective cohort of 164 mCRC patients, body composition was assessed using BIA before first-line chemotherapy. Metrics evaluated included the extracellular water/total body water ratio (ECW/TBW), skeletal muscle mass, body fat mass, protein, and mineral levels. This study examined the relationship between these parameters and survival outcomes and their impact on chemotherapy-induced toxicity and relative dose intensity.

Results

Patients with a higher ECW/TBW ratio had significantly lower overall survival (OS) (p < 0.001) across quartiles (median OS: Q1 = 38.6 months, Q4 = 19.1 months) and a significantly lower progression-free survival (median progression-free survival: Q1 = 10.5 months, Q4 = 8.3 months; p = 0.03). Multivariate analysis identified ECW/TBW as an independent predictor of OS (hazard ratio: 2.12; 95 % confidence interval: 1.36–3.23; p < 0.001). Subgroup analysis indicated a significant interaction between ECW/TBW quartiles and the effectiveness of anti-endothelial growth factor receptor and anti-vascular endothelial growth factor therapies on overall survival (p for interaction <0.001). Body composition was significantly associated with chemotherapy relative dose intensity and hematologic adverse events, particularly thrombocytopenia, which was significantly correlated with ECW/TBW, skeletal muscle mass, lean body mass, and protein levels.

Conclusion

This study highlights the value of comprehensive body composition assessment using BIA in predicting outcomes for patients with mCRC, supporting its incorporation into clinical practice for enhanced patient care.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.