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Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma
The relationship between sarcopenia and treatment outcomes, especially in patients with hepatocellular carcinoma (HCC) undergoing stereotactic body radiotherapy (SBRT) has not been well-explored. This study aimed to investigate the effects of sarcopenia on the survival and toxicity after SBRT in pat...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646692/ https://www.ncbi.nlm.nih.gov/pubmed/36352042 http://dx.doi.org/10.1038/s41598-022-21443-6 |
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author | Yang, Jen-Fu Huang, Wen-Yen Lo, Cheng-Hsiang Lee, Meei-Shyuan Lin, Chun-Shu Shen, Po-Chien Dai, Yang-Hong Wang, Ying-Fu Chen, Teng-Wei |
author_facet | Yang, Jen-Fu Huang, Wen-Yen Lo, Cheng-Hsiang Lee, Meei-Shyuan Lin, Chun-Shu Shen, Po-Chien Dai, Yang-Hong Wang, Ying-Fu Chen, Teng-Wei |
author_sort | Yang, Jen-Fu |
collection | PubMed |
description | The relationship between sarcopenia and treatment outcomes, especially in patients with hepatocellular carcinoma (HCC) undergoing stereotactic body radiotherapy (SBRT) has not been well-explored. This study aimed to investigate the effects of sarcopenia on the survival and toxicity after SBRT in patients with HCC. We included 137 patients with HCC treated with SBRT between 2008 and 2018. Sarcopenia was defined as a skeletal muscle index (SMI) of < 49 cm(2)/m(2) for men and < 31 cm(2)/m(2) for women using computed tomography images at the mid-level of the third lumbar vertebra. The SMI change was presented as the change per 90 days. The Kaplan–Meier method was used for survival estimation, and the Cox regression was used to determine prognosticators. Sarcopenia was present in 67 of 137 eligible patients. With the median follow-up of 14.1 months and 32.7 months in the entire cohort and in those alive, respectively, patients with pre-SBRT sarcopenia or SMI loss ≥ 7% after SBRT had worse overall survival than their counterparts. Significant survival predictors on multivariate analysis were SMI loss ≥ 7% after SBRT [hazard ratio (HR): 1.96, p = 0.013], presence of extrahepatic metastasis (HR: 3.47, p < 0.001), neutrophil-to-lymphocyte ratio (HR: 1.79, p = 0.027), and multiple tumors (HR: 2.19, p = 0.003). Separate Cox models according to the absence and presence of pre-SBRT sarcopenia showed that SMI loss ≥ 7% remained a significant survival predictor in patients with sarcopenia (HR: 3.06, p = 0.017) compared with those without sarcopenia. SMI loss ≥ 7% is also a predictor of the Child–Pugh score increase by ≥ 2 points after SBRT. SMI loss ≥ 7% after SBRT is a significant prognostic factor for worse survival and is associated with liver toxicity compared with pre-SBRT sarcopenia. |
format | Online Article Text |
id | pubmed-9646692 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-96466922022-11-15 Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma Yang, Jen-Fu Huang, Wen-Yen Lo, Cheng-Hsiang Lee, Meei-Shyuan Lin, Chun-Shu Shen, Po-Chien Dai, Yang-Hong Wang, Ying-Fu Chen, Teng-Wei Sci Rep Article The relationship between sarcopenia and treatment outcomes, especially in patients with hepatocellular carcinoma (HCC) undergoing stereotactic body radiotherapy (SBRT) has not been well-explored. This study aimed to investigate the effects of sarcopenia on the survival and toxicity after SBRT in patients with HCC. We included 137 patients with HCC treated with SBRT between 2008 and 2018. Sarcopenia was defined as a skeletal muscle index (SMI) of < 49 cm(2)/m(2) for men and < 31 cm(2)/m(2) for women using computed tomography images at the mid-level of the third lumbar vertebra. The SMI change was presented as the change per 90 days. The Kaplan–Meier method was used for survival estimation, and the Cox regression was used to determine prognosticators. Sarcopenia was present in 67 of 137 eligible patients. With the median follow-up of 14.1 months and 32.7 months in the entire cohort and in those alive, respectively, patients with pre-SBRT sarcopenia or SMI loss ≥ 7% after SBRT had worse overall survival than their counterparts. Significant survival predictors on multivariate analysis were SMI loss ≥ 7% after SBRT [hazard ratio (HR): 1.96, p = 0.013], presence of extrahepatic metastasis (HR: 3.47, p < 0.001), neutrophil-to-lymphocyte ratio (HR: 1.79, p = 0.027), and multiple tumors (HR: 2.19, p = 0.003). Separate Cox models according to the absence and presence of pre-SBRT sarcopenia showed that SMI loss ≥ 7% remained a significant survival predictor in patients with sarcopenia (HR: 3.06, p = 0.017) compared with those without sarcopenia. SMI loss ≥ 7% is also a predictor of the Child–Pugh score increase by ≥ 2 points after SBRT. SMI loss ≥ 7% after SBRT is a significant prognostic factor for worse survival and is associated with liver toxicity compared with pre-SBRT sarcopenia. Nature Publishing Group UK 2022-11-09 /pmc/articles/PMC9646692/ /pubmed/36352042 http://dx.doi.org/10.1038/s41598-022-21443-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Yang, Jen-Fu Huang, Wen-Yen Lo, Cheng-Hsiang Lee, Meei-Shyuan Lin, Chun-Shu Shen, Po-Chien Dai, Yang-Hong Wang, Ying-Fu Chen, Teng-Wei Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
title | Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
title_full | Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
title_fullStr | Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
title_full_unstemmed | Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
title_short | Significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
title_sort | significant muscle loss after stereotactic body radiotherapy predicts worse survival in patients with hepatocellular carcinoma |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9646692/ https://www.ncbi.nlm.nih.gov/pubmed/36352042 http://dx.doi.org/10.1038/s41598-022-21443-6 |
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