Characterization of Anthropometric Changes that Occur During Neoadjuvant Therapy for Potentially Resectable Pancreatic Cancer

被引:135
作者
Cooper, Amanda B. [1 ]
Slack, Rebecca [2 ]
Fogelman, David [3 ]
Holmes, Holly M. [4 ,5 ]
Petzel, Maria [6 ,7 ]
Parker, Nathan [6 ]
Balachandran, Aparna [8 ]
Garg, Naveen [8 ]
Ngo-Huang, An [9 ]
Varadhachary, Gauri [3 ]
Evans, Douglas B. [10 ]
Lee, Jeffrey E. [6 ]
Aloia, Thomas [6 ]
Conrad, Claudius [6 ]
Vauthey, Jean-Nicolas [6 ]
Fleming, Jason B. [6 ]
Katz, Matthew H. G. [6 ]
机构
[1] Penn State Hershey Med Ctr, Dept Surg, Hershey, PA 17033 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept GI Med Oncol, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Healthy Aging Clin, Houston, TX 77030 USA
[5] Univ Texas MD Anderson Canc Ctr, Gen Internal Med, Houston, TX 77030 USA
[6] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, Houston, TX 77030 USA
[7] Univ Texas MD Anderson Canc Ctr, Dept Clin Nutr, Houston, TX 77030 USA
[8] Univ Texas MD Anderson Canc Ctr, Dept Diagnost Radiol, Houston, TX 77030 USA
[9] Univ Texas MD Anderson Canc Ctr, Dept Rehabilitat Med, Houston, TX 77030 USA
[10] Med Coll Wisconsin, Dept Surg, Milwaukee, WI 53226 USA
关键词
GEMCITABINE-BASED CHEMORADIATION; VISCERAL ADIPOSE-TISSUE; OPERABLE BREAST-CANCER; SINGLE-SLICE AREAS; BODY-MASS INDEX; RECTAL-CANCER; PREOPERATIVE GEMCITABINE; VASCULAR RESECTION; SURVIVAL DURATION; MARGIN STATUS;
D O I
10.1245/s10434-014-4285-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Little is known about changes in body composition that may occur during neoadjuvant therapy for pancreatic cancer. This study was designed to characterize these changes and their potential relationships with therapeutic outcomes. The study population consisted of patients with potentially resectable pancreatic cancer treated on a phase II trial of neoadjuvant chemotherapy and chemoradiation. Skeletal muscle and adipose tissue compartments were measured before and after administration of neoadjuvant therapy using SliceOMatic software (TomoVision, 2012) and protocol-mandated CT scans. Sarcopenia was defined using gender-adjusted norms. Among 89 eligible patients, 46 (52 %) patients met anthropometric criteria for sarcopenia prior to the initiation of neoadjuvant therapy. Further depletion of skeletal muscle, visceral adipose tissue, and subcutaneous adipose tissue occurred during neoadjuvant therapy, but these losses did not preclude the performance of potentially curative surgery. Degree of skeletal muscle loss correlated with disease-free survival while visceral adipose loss was associated with overall and progression-free survival. However, completion of all therapy, including pancreatectomy, was the only independently significant predictor of outcome in a multivariate analysis of overall survival. These data suggest that body composition analysis of standard CT images may provide clinically relevant information for patients with potentially resectable pancreatic cancer who receive neoadjuvant therapy. Anthropometric changes must be considered in the design of preoperative therapy regimens, and further efforts should focus on maintenance of muscle and visceral adipose tissue in the preoperative setting.
引用
收藏
页码:2416 / 2423
页数:8
相关论文
共 36 条
[1]  
Ancona E, 2001, CANCER, V91, P2165, DOI 10.1002/1097-0142(20010601)91:11<2165::AID-CNCR1245>3.0.CO
[2]  
2-H
[3]   Marked changes in body composition following neoadjuvant chemotherapy for oesophagogastric cancer [J].
Awad, Sherif ;
Tan, Benjamin H. ;
Cui, Helen ;
Bhalla, Ashish ;
Fearon, Kenneth C. H. ;
Parsons, Simon L. ;
Caton, James A. ;
Lobo, Dileep N. .
CLINICAL NUTRITION, 2012, 31 (01) :74-77
[4]   Sarcopenia Is Linked to Treatment Toxicity in Patients With Metastatic Colorectal Cancer [J].
Barret, Maximilien ;
Antoun, Sami ;
Dalban, Cecile ;
Malka, David ;
Mansourbakht, Touraj ;
Zaanan, Aziz ;
Latko, Ewa ;
Taieb, Julien .
NUTRITION AND CANCER-AN INTERNATIONAL JOURNAL, 2014, 66 (04) :583-589
[5]   Quantitative Measures of Visceral Adiposity and Body Mass Index in Predicting Rectal Cancer Outcomes after Neoadjuvant Chemoradiation [J].
Clark, Whalen ;
Siegel, Erin M. ;
Chen, Y. Ann ;
Zhao, Xiuhua ;
Parsons, Colin M. ;
Hernandez, Jonathan M. ;
Weber, Jill ;
Thareja, Shalini ;
Choi, Junsung ;
Shibata, David .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2013, 216 (06) :1070-1081
[6]  
COX DR, 1972, J R STAT SOC B, V34, P187
[7]   Relationships Among Body Mass Index, Longitudinal Body Composition Alterations, and Survival in Patients With Locally Advanced Pancreatic Cancer Receiving Chemoradiation: A Pilot Study [J].
Dalal, Shalini ;
Hui, David ;
Bidaut, Luc ;
Lem, Kristen ;
Del Fabbro, Egidio ;
Crane, Christopher ;
Reyes-Gibby, Cielito C. ;
Bedi, Deepak ;
Bruera, Eduardo .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2012, 44 (02) :181-191
[8]   An overview of amines as nutritional supplements to counteract cancer cachexia [J].
de Campos-Ferraz, Patricia Lopes ;
Andrade, Isabel ;
das Neves, Willian ;
Hangai, Isabela ;
Rodrigues Alves, Christiano Robles ;
Lancha, Antonio Herbert, Jr. .
JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE, 2014, 5 (02) :105-110
[9]   The Relationship Between Body Composition and Response to Neoadjuvant Chemotherapy in Women with Operable Breast Cancer [J].
Del Fabbro, Egidio ;
Parsons, Henrique ;
Warneke, Carla L. ;
Pulivarthi, Kalyan ;
Litton, Jennifer K. ;
Dev, Rony ;
Palla, Shana L. ;
Brewster, Abenaa ;
Bruera, Eduardo .
ONCOLOGIST, 2012, 17 (10) :1240-1245
[10]   Omega-3 fatty acids and protein metabolism: enhancement of anabolic interventions for sarcopenia [J].
Di Girolamo, Filippo Giorgio ;
Situlin, Roberta ;
Mazzucco, Sara ;
Valentini, Roberto ;
Toigo, Gabriele ;
Biolo, Gianni .
CURRENT OPINION IN CLINICAL NUTRITION AND METABOLIC CARE, 2014, 17 (02) :145-150