期刊
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY
卷 26, 期 7, 页码 1293-1303出版社
SPRINGER JAPAN KK
DOI: 10.1007/s10147-021-01912-0
关键词
Elderly patients; Cachexia; Palliative chemotherapy; Pancreatic cancer; Sarcopenia
类别
Cachexia and sarcopenia significantly impact the clinical course of elderly pancreatic cancer patients undergoing chemotherapy, with cachexia being a more predictive factor while sarcopenia has a lesser effect on patients' clinical outcomes.
Background Elderly pancreatic cancer (PC) patients are often considered vulnerable to treatment and standard treatment strategy for this subpopulation is uncertain. Cachexia and sarcopenia are reported to be associated with reduced physical performance, reduced anti-tumor response, increased chemotherapy toxicity, and poor prognosis in several malignancies. The aim of this study was to evaluate the impact of cachexia and sarcopenia on the clinical course of elderly PC patients receiving chemotherapy. Methods We retrospectively investigated consecutive elderly metastatic PC patients (>= 75 years) treated with chemotherapy at our institution between January 2015 and April 2020. Skeletal muscle index was calculated at the third lumbar vertebra using pretreatment computed tomography. We evaluated time to treatment failure (TTF), progression-free survival (PFS), overall survival (OS), early treatment discontinuation, relative dose intensity (RDI), and severe adverse events (AEs). Results Among 80 patients included (gemcitabine plus nab-paclitaxel [GnP] 52; gemcitabine 21; S1 6; modified FOLFIRINOX 1), cachexia and sarcopenia were present in 48 (60%) and 61 (76%) patients, respectively. Cachexia was associated with older age, worse performance status, higher level of neutrophil to lymphocyte ratio, worse nutritional status, and shorter TTF and PFS. Furthermore, it was also associated with early treatment discontinuation, reduced RDI of nab-paclitaxel, and increased incidence of grade 4 neutropenia in patients receiving GnP. On the other hand, sarcopenia had less impact on the clinical course of elderly PC patients. Conclusions In our experience, cachexia was considered an effective tool in the management of elderly PC patients receiving palliative chemotherapy.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据