在肿瘤环境中改进对身体组成动力学中两性二态性的分析：范围综述

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-04-18 DOI:10.1016/j.clnesp.2025.03.169

Ravneet Kaur, Pamela N. Klassen, Vera C. Mazurak

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引用次数: 0

摘要

背景和目的化疗会导致骨骼肌和脂肪组织的损失，这两者都是癌症诊断后重要的预后指标。男性和女性对治疗癌症的药物的反应可能不同。鉴于文献中的高度异质性，本综述的目的是评估在癌症定向治疗期间，男性和女性比较肌肉和脂肪组织变化报告的方法学变异性。方法检索相关数据库，分别检索基于纵向CT的男性和女性实体瘤患者体成分变化的相关文献。结果在符合纳入标准的29项研究中，22项为回顾性研究，7项为前瞻性研究。大多数研究报道的是胃肠道肿瘤[n=24]。在集体参与者（n= 5139）中，32%为女性。在一半的研究中，女性的代表性不足。在21/29项研究中，将男性和女性的基线特征结合起来，阻碍了了解疾病分期、化疗类型和合并症对男女经历的肌肉和脂肪变化的影响。多种化疗方案联合（n=24），没有以性别特异性的方式报道（n=26）。结论虽然报道癌症治疗期间身体成分变化的文献很多，但研究设计和报道存在问题，无法进行荟萃分析。在一项研究中，不成比例的男性和女性，癌症类型的显著异质性和化疗方案的评估共同构成了分析特定化疗方案对性别肌肉和脂肪变化的影响的挑战。需要采取策略，以特定性别的方式规范这组文献，以改善证据综合。

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Improving analysis of sexual dimorphism in body composition dynamics in the oncology setting: A scoping review

Background and aims

Chemotherapy treatments induce loss of skeletal muscle and adipose tissue each of which are important prognostic indicators after a cancer diagnosis. Males and females may respond differently to drugs used to treat cancer. Given the high degree of heterogeneity in the literature, the objective of this scoping review is to evaluate the methodological variability in reporting of muscle and adipose tissue changes comparing males and females during cancer-directed treatment.

Methods

Relevant databases were searched for papers reporting longitudinal CT based body composition changes separately for males and females in solid tumors.

Results

Of the 29 studies that met inclusion criteria, 22 were retrospective and 7 were prospective. The majority of studies reported on gastrointestinal cancers [n=24]. Among collective participants (n= 5139), 32% were females. Females were under represented in half the studies. For 21/29 studies, baseline characteristics were combined for males and females, hindering the ability to understand the effect of disease stage, chemotherapy type and co-morbidities on muscle and fat changes experienced by each sex. Multiple chemotherapy regimens were combined (n=24) and not reported in a sex-specific way (n=26).

Conclusion

While the literature reporting body composition changes during cancer treatment is abundant, study design and reporting is problematic and precludes metaanalysis. Disproportionate numbers of males and females, marked heterogeneity in cancer types and chemotherapy regimens evaluated within a single study collectively pose challenges in analysing the impact of specific chemotherapy regimens on muscle and adipose change by sex. Strategies to standardize this set of literature in a sex specific way are required to improve evidence synthesis.

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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.