Frontiers in nutrition · 2026
The impact of sarcopenia on short-term efficacy, toxic and adverse reactions, and prognosis in patients with non-small cell lung cancer undergoing concurrent chemoradiotherapy.
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Yuan Yin, Yu Zhao, Ma Yanchen, Wang Kaining, Ding Jianming, He Zelai, Wang Gengming
Аннотация
BACKGROUND: Sarcopenia (SP) is an important indicator for evaluating the nutritional status of cancer patients, but its impact on short-term efficacy, toxic and adverse reactions, and long-term survival in patients with non-small cell lung cancer (NSCLC) undergoing concurrent chemoradiotherapy (CRT) remains incompletely understood.
METHODS: Clinical data of 86 newly diagnosed NSCLC patients who were admitted to Bengbu Medical University First Affiliated Hospital from January 2020 to June 2024 were collected. The skeletal muscle index (SMI) was calculated based on computed tomography (CT) images at the mid-vertebral body of L3. Patients were divided into the SP group (46 cases, 53.5%) and the non-sarcopenia group (40 cases, 46.5%). The incidence of adverse events, short-term efficacy (per RECIST 1.1 criteria), 1 and 3-year overall survival (OS), and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression model was used to analyze prognostic factors.
RESULTS: Follow-up was conducted until July 31, 2025. The objective response rate (ORR) in the sarcopenia group was significantly lower than that in the non-sarcopenia group (56.5 vs. 80.0%, χ2 = 5.371, P = 0.020), and the complete response rate (CR) showed a decreasing trend (4.3 vs. 20.0%, P = 0.055). There was no significant difference in the incidence of severe adverse events between the two groups (P > 0.05), but the incidence of radiation pneumonitis was higher in the sarcopenia group (43.5 vs. 25.0%). The median OS of the entire cohort was 24 months (95% confidence interval [CI] 18 ~30 months), and the median OS in the sarcopenia group (19 months) was significantly shorter than that in the non-sarcopenia group (36 months, P < 0.001). Multivariate Cox proportional hazards regression analysis revealed that sarcopenia (hazard ratio [HR] = 1.729, 95% CI 1.024-2.910, P = 0.040), Karnofsky Performance Status (KPS) score < 80, serum albumin < 40.0 g/L, and intermuscular adipose tissue (IMAT) ≥12.46 cm2 were independent prognostic factors for OS.
CONCLUSION: SP can reduce the short-term efficacy of CRT and shorten OS in NSCLC patients. It serves as an independent prognostic factor for these patients, providing guidance for formulating clinical treatment strategies.
METHODS: Clinical data of 86 newly diagnosed NSCLC patients who were admitted to Bengbu Medical University First Affiliated Hospital from January 2020 to June 2024 were collected. The skeletal muscle index (SMI) was calculated based on computed tomography (CT) images at the mid-vertebral body of L3. Patients were divided into the SP group (46 cases, 53.5%) and the non-sarcopenia group (40 cases, 46.5%). The incidence of adverse events, short-term efficacy (per RECIST 1.1 criteria), 1 and 3-year overall survival (OS), and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression model was used to analyze prognostic factors.
RESULTS: Follow-up was conducted until July 31, 2025. The objective response rate (ORR) in the sarcopenia group was significantly lower than that in the non-sarcopenia group (56.5 vs. 80.0%, χ2 = 5.371, P = 0.020), and the complete response rate (CR) showed a decreasing trend (4.3 vs. 20.0%, P = 0.055). There was no significant difference in the incidence of severe adverse events between the two groups (P > 0.05), but the incidence of radiation pneumonitis was higher in the sarcopenia group (43.5 vs. 25.0%). The median OS of the entire cohort was 24 months (95% confidence interval [CI] 18 ~30 months), and the median OS in the sarcopenia group (19 months) was significantly shorter than that in the non-sarcopenia group (36 months, P < 0.001). Multivariate Cox proportional hazards regression analysis revealed that sarcopenia (hazard ratio [HR] = 1.729, 95% CI 1.024-2.910, P = 0.040), Karnofsky Performance Status (KPS) score < 80, serum albumin < 40.0 g/L, and intermuscular adipose tissue (IMAT) ≥12.46 cm2 were independent prognostic factors for OS.
CONCLUSION: SP can reduce the short-term efficacy of CRT and shorten OS in NSCLC patients. It serves as an independent prognostic factor for these patients, providing guidance for formulating clinical treatment strategies.