BACKGROUND Assessment of handgrip strength and fat-free mass provides quick and objective information on muscle performance and mass that might complement subjective World Health Organization Performance Status (WHO PS). We investigated to what extent the presence of pre-treatment handgrip weakness and low fat-free mass index (FFMI) provides additional prognostic information on top of well-established prognostic factors (including WHO PS) in non-small cell lung cancer (NSCLC) patients selected for curative-intent (chemo)radiation. METHODS Prospectively, patients with early and locally advanced NSCLC (stages I-III) treated with (chemo)radiation were enrolled. Handgrip weakness and low FFMI, derived from bioelectrical impedance analysis, were defined using normative values and were correlated with overall survival (OS). RESULTS We included 936 patients (age 68 ± 10 years; 64% male; 19% stage I, 9% stage II, and 72% stage III disease; 26% handgrip weakness; 27% low FFMI). In patients with good performance status (WHO PS 0 or 1), handgrip weakness and low FFMI were significant prognostic factors for OS, after adjustment for age, gender, disease stage, and co-morbidities. The combined presence of handgrip weakness and low FFMI was a strong prognostic factor for OS when compared with patients with normal handgrip strength and FFMI (hazard ratio: 1.79, 95% confidence interval: 1.34-2.40, P < 0.0001). In patients with impaired performance status (WHO PS ≥ 2, 19% of sample), handgrip weakness and low FFMI were not related to OS. CONCLUSIONS In early and locally advanced NSCLC patients treated with curative-intent (chemo)radiation who have good WHO PS, patients with combined handgrip weakness and low FFMI have the worst prognosis.

中文翻译：

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根治性放疗治疗的非小细胞肺癌的手部无力，无脂肪量少和整体存活率。

背景技术对握力和无脂肪质量的评估提供了有关肌肉性能和质量的快速而客观的信息，这些信息可能会补充主观世界卫生组织的绩效状况（WHO PS）。我们调查了在非小细胞肺癌（NSCLC）中公认的预后因素（包括WHO PS）的基础上，治疗前手柄无力和低无脂肪质量指数（FFMI）的存在在何种程度上可提供其他预后信息。选择进行治疗性放射治疗的患者。方法纳入了接受（化学）放疗的早期和局部晚期NSCLC患者（I-III期）。由生物电阻抗分析得出的手柄无力和低FFMI是使用标准值定义的，并与总生存期（OS）相关。结果我们纳入了936例患者（年龄68±10岁；男性64％； I期19％，II期9％和III期72％；手握无力26％； FFMI低27％）。在调整了年龄，性别，疾病分期和合并症之后，对于表现良好状态（WHO PS 0或1）的患者，握力减弱和FFMI较低是OS的重要预后因素。与具有正常握力和FFMI的患者相比，合并握力弱和FFMI低是OS的强预后因素（危险比：1.79，95％置信区间：1.34-2.40，P <0.0001）。在表现状态受损的患者中（WHO PS≥2，占样本的19％），手握无力和低FFMI与OS无关。结论在早期和局部晚期NSCLC患者中，接受过治愈性（化学）放疗的WHO WHO PS良好，