Purpose

Cachexia influences the patient’s physical wellbeing and quality of life, and the patient’s ability to tolerate their cancer therapies, especially cytotoxic chemotherapy. The purpose of this study was to investigate the frequency and timing of onset of cancer cachexia during chemotherapy and its association with prognosis and toxicity in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

We performed a retrospective study in patients who underwent first-line chemotherapy after diagnosis of advanced PDAC between 6 June 2008 and 31 March 2017. Base cachexia (weight loss up to 6 months before starting first-line chemotherapy) and follow-up cachexia (after starting first-line chemotherapy) were defined as weight loss > 2% with a body mass index (BMI) < 20 kg/m² or weight loss > 5%.

Results

A total of 150 patients were registered. The median age and BMI were 65 years and 21.7 kg/m², respectively. Base cachexia occurred in 50% of patients. Follow-up cachexia occurred in 32% within 12 weeks of starting first-line chemotherapy, reaching 64% at 1 year. Overall survival was not significantly different between patients with and without follow-up cachexia, regardless of whether cancer cachexia occurred within 12, 24, or 48 weeks of starting first-line treatment. Appetite loss, fatigue, nausea, and diarrhea were more frequent in patients with follow-up cachexia than in those without follow-up cachexia.

Conclusion

Follow-up cachexia had an early onset, but was not a prognostic factor for overall survival in patients with PDAC. Some adverse events tended to be more frequent in patients with follow-up cachexia than in those without follow-up cachexia.

中文翻译：

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晚期胰腺导管腺癌化疗期间癌症恶病质的发生率和频率。

 目的

恶病质影响患者的身体健康和生活质量，以及患者耐受癌症治疗（尤其是细胞毒性化疗）的能力。本研究的目的是调查胰腺导管腺癌 (PDAC) 患者化疗期间癌症恶病质发作的频率和时间及其与预后和毒性的关系。

 方法

我们对 2008 年 6 月 6 日至 2017 年 3 月 31 日期间诊断为晚期 PDAC 后接受一线化疗的患者进行了一项回顾性研究。基础恶病质（开始一线化疗前 6 个月内体重减轻）和随访恶病质（术后恶病质）开始一线化疗）被定义为体重减轻> 2%且体重指数（BMI）< 20 kg/m ²或体重减轻> 5%。

 结果

共有150名患者登记。中位年龄和BMI分别为65岁和21.7 kg/m ² 。 50%的患者出现基础恶病质。一线化疗开始后 12 周内，32% 的患者出现随访恶病质，1 年后达到 64%。无论癌症恶病质是否发生在开始一线治疗后 12、24 或 48 周内，有或没有后续恶病质的患者的总生存率没有显着差异。与没有后续恶病质的患者相比，有后续恶病质的患者更容易出现食欲减退、疲劳、恶心和腹泻。

 结论

随访恶病质发病较早，但不是 PDAC 患者总生存期的预后因素。一些不良事件在有后续恶病质的患者中比没有后续恶病质的患者更常见。