胰腺癌新辅助化疗期间骨骼肌质量的丧失与胰腺切除术后继续S-1辅助化疗有关

IF 1.6 4区医学 Q4 ONCOLOGY Anticancer research Pub Date : 2024-10-01 DOI:10.21873/anticanres.17286

Shinnosuke Kawahara, Toru Aoyama, Itaru Hashimoto, Rei Kanemoto, Naohiko Matsushita, Mariko Kamiya, Yosuke Atsumi, Yukio Maezawa, Keisuke Kazama, Masaaki Murakawa, Satoshi Kobayashi, Makoto Ueno, Naoto Yamamoto, Takashi Oshima, Norio Yukawa, Aya Saito, Soichiro Morinaga

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引用次数: 0

摘要

背景/目的：虽然围手术期化疗提高了患者的生存率，但由于食物摄入量和体力下降，化疗期间可能会出现肌肉疏松症。然而，有关胰腺癌患者在新辅助化疗期间发生肌肉疏松症和身体成分变化的报道却很少。本研究旨在确定新辅助化疗期间骨骼肌质量变化对围术期化疗和手术切除患者S-1辅助化疗临床疗程的影响：我们回顾性地纳入了159例接受新辅助化疗和手术切除，然后接受S-1辅助化疗的胰腺癌患者。我们使用腹部计算机断层扫描和 SliceOmatic 软件评估了新辅助化疗期间骨骼肌质量的变化。我们还研究了新辅助化疗期间骨骼肌质量指数变化率（Δ%SMI）与继续S-1辅助化疗之间的关联：结果：88 名（55.3%）患者的骨骼肌质量下降（Δ%SMI 结论：新辅助化疗期间骨骼肌质量下降：胰腺癌新辅助化疗期间骨骼肌质量的丧失影响了胰腺切除术后S-1辅助化疗的继续进行。因此，应慎重考虑改善新辅助化疗期间骨骼肌质量的损失，以提高辅助化疗的持续率和胰腺癌患者的生存率。

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Loss of Skeletal Muscle Mass During Neoadjuvant Chemotherapy for Pancreatic Cancer Is Related to the Continuation of S-1 Adjuvant Chemotherapy After Pancreatectomy.

Background/aim: Although perioperative chemotherapy has improved patient survival, sarcopenia may occur during chemotherapy owing to decreased food intake and physical strength. However, reports on the occurrence of sarcopenia and changes in body composition in patients with pancreatic cancer during neoadjuvant chemotherapy are scarce. This study aimed to determine the effect of changes in skeletal muscle mass during neoadjuvant chemotherapy on the S-1 adjuvant chemotherapy clinical course in patients who underwent perioperative chemotherapy and surgical resection.

Patients and methods: We retrospectively enrolled 159 patients with pancreatic cancer who underwent neoadjuvant chemotherapy and surgical resection, followed by S-1 adjuvant chemotherapy. We evaluated changes in skeletal muscle mass during neoadjuvant chemotherapy using abdominal computed tomography and the SliceOmatic software. The association between the rate of change in skeletal muscle mass index (Δ%SMI) during neoadjuvant chemotherapy and the continuation of S-1 adjuvant chemotherapy was investigated.

Results: Eighty-eight (55.3%) patients lost skeletal muscle mass (Δ%SMI <0) during neoadjuvant chemotherapy with a significantly low S-1 adjuvant completion rate (p=0.02). Δ%SMI <0 was an independent risk factor for the continuation of S-1 adjuvant chemotherapy (hazard ratio=1.924, 95% confidence interval=1.002-3.695, p=0.049). Moreover, the lower the Δ%SMI, the lower the S-1 continuation rate (p=0.022).

Conclusion: Loss of skeletal muscle mass during neoadjuvant chemotherapy for pancreatic cancer affected the continuation of S-1 adjuvant chemotherapy after pancreatic resection. Therefore, ameliorating loss of skeletal muscle mass during neoadjuvant chemotherapy should be carefully considered to improve the continuation rate of adjuvant chemotherapy and the survival of patients with pancreatic cancer.

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.