Purpose

Cancer cachexia (CC) is a syndrome characterised by an ongoing loss of skeletal muscle mass associated with reduced tolerance to treatment. This study explored the prevalence and severity of CC in advanced non-small cell lung cancer (NSCLC) patients and determined its relationship with chemotherapy outcomes.

Methods

CC was classified into a four-stage model: no cachexia, pre-cachexia (PC), cachexia and refractory cachexia (RC) with categorisation determined from biochemical and body composition and performance assessment. Associations between the stage of cachexia and chemotherapy outcomes including radiological response, the number of chemotherapy cycles completed and the number of cycles delayed or dose reduced were explored.

Results

Twenty-four patients were included with 4 (18%) classified as having no cachexia, 4 (18%) PC, 3 (14%) cachexia (13.6%), and 11 (50%) RC. No association was observed between the stage of cachexia and the radiological response to chemotherapy number of cycles delayed or the number of cycle’s dose reduced; however, there was an association with the number of cycles completed (p = 0.030). An association between C-reactive protein (CRP) and the number of chemotherapy cycles completed (p = 0.044) and the number of dose reductions (p = 0.044) was also identified.

Conclusions

Limited conclusions can be drawn given the small sample size. However, the majority of patients presented with some degree of cachexia at diagnosis. A relationship was identified between the increasing severity of cachexia and a lower number of chemotherapy cycles completed, as well as between CRP and the number of chemotherapy cycles completed and the number of dose reductions required, and therefore warrants further exploration in larger studies.

中文翻译：

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确定晚期非小细胞肺癌中癌症恶病质的患病率和严重程度及其与化疗结果的关系。

 目的

癌症恶病质（CC）是一种综合征，其特征是骨骼肌质量持续丧失，且与治疗耐受性降低相关。本研究探讨了晚期非小细胞肺癌 (NSCLC) 患者 CC 的患病率和严重程度，并确定了其与化疗结果的关系。

 方法

CC分为四阶段模型：无恶病质、恶病质前期（PC）、恶病质和难治性恶病质（RC），根据生化和身体成分以及性能评估确定分类。探讨了恶病质阶段与化疗结果之间的关联，包括放射学反应、完成的化疗周期数以及延迟或剂量减少的周期数。

 结果

纳入 24 名患者，其中 4 名（18%）被分类为无恶病质，4 名（18%）为 PC，3 名（14%）为恶病质（13.6%），11 名（50%）为 RC。未观察到恶病质阶段与化疗周期数延迟或周期数减少的放射学反应之间存在关联；然而，与完成的周期数存在关联（ p = 0.030）。还确定了 C 反应蛋白 (CRP) 与完成的化疗周期数 ( p = 0.044) 和剂量减少次数 ( p = 0.044) 之间的关联。

 结论

鉴于样本量较小，只能得出有限的结论。然而，大多数患者在诊断时表现出某种程度的恶病质。恶病质严重程度增加与完成的化疗周期数减少之间以及 CRP 与完成的化疗周期数和所需剂量减少次数之间存在关系，因此值得在更大规模的研究中进一步探索。