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Prognostic Significance of the Cachexia Index in Patients with Non-Small-Cell Lung Cancer and Brain Metastases after Stereotactic Radiotherapy.
Xu, Hui; Zhang, Bin; Zhang, Yongqian; Yang, Chunchun; Bo, Changwen; Guo, Yuanyuan; Cheng, Yuan; He, Li.
Afiliación
  • Xu H; Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China.
  • Zhang B; Department of Emergency, First Hospital of Hebei Medical University, Shijiazhuang, China.
  • Zhang Y; Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China.
  • Yang C; Department of Digestion, First Hospital of Hebei Medical University, Shijiazhuang, China.
  • Bo C; Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China.
  • Guo Y; Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China.
  • Cheng Y; School of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, China.
  • He L; Department of Oncology, First Hospital of Hebei Medical University, Shijiazhuang, China.
Clin Med Insights Oncol ; 18: 11795549231222362, 2024.
Article en En | MEDLINE | ID: mdl-38440045
ABSTRACT

Background:

The cachexia index (CXI) has been proposed as a novel biomarker of cancer cachexia. We aimed to investigate the association between CXI and survival outcomes after stereotactic radiotherapy (SRT) in patients with non-small cell lung cancer (NSCLC) and brain metastases.

Methods:

Data from 145 patients with NSCLC, who underwent SRT for brain metastases between April 2016 and August 2020, were retrospectively analyzed. Cachexia index was calculated as skeletal muscle index (SMI) × serum albumin level/neutrophil-to-lymphocyte ratio, whereas SMI was calculated from computed tomography images captured at the L1 level. Kaplan-Meier curves and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS). The prognostic values of CXI and other cachexia biomarkers were assessed using receiver operating characteristic (ROC) curve analysis.

Results:

Lower pretreatment CXI (<30.8) was significantly associated with older age (P = .039), lower Karnofsky performance score (P = .009), and a high likelihood of extracranial metastases (P = .001). Patients with a lower pretreatment CXI had a significantly shorter PFS and OS than those with a higher CXI (P < .001). Multivariate analysis revealed that pretreatment CXI was an independent risk factor for both PFS, hazard ratio (HR) = 2.375; 95% confidence interval (CI) = 1.610-3.504; P < .001, and OS, HR = 2.340; 95% CI = 1.562-3.505; P < .001. Compared with other biomarkers, pretreatment CXI had the highest area under the ROC curve value for prognostic assessment, reaching 0.734. Moreover, the loss of CXI was a strong risk factor for survival independent of pretreatment CXI (P = .011).

Conclusions:

Cachexia index may serve as a clinically useful tool for predicting survival outcomes of patients with NSCLC and brain metastases who undergo SRT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Med Insights Oncol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Med Insights Oncol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos