TY - JOUR
T1 - Body composition, symptoms, and survival in advanced cancer patients referred to a phase I service
AU - Parsons, Henrique A.
AU - Baracos, Vickie E.
AU - Dhillon, Navjot
AU - Hong, David S.
AU - Kurzrock, Razelle
PY - 2012/1/3
Y1 - 2012/1/3
N2 - Background: Body weight and body composition are relevant to the outcomes of cancer and antineoplastic therapy. However, their role in Phase I clinical trial patients is unknown. Methods: We reviewed symptom burden, body composition, and survival in 104 patients with advanced cancer referred to a Phase I oncology service. Symptom burden was analyzed using the MD Anderson Symptom Assessment Inventory(MDASI); body composition was evaluated utilizing computerized tomography(CT) images. A body mass index (BMI)≥25 kg/m 2 was considered overweight. Sarcopenia, severe muscle depletion, was assessed using CT-based criteria. Results: Most patients were overweight (n = 65, 63%); 53 patients were sarcopenic (51%), including 79% of patients with a BMI<25 kg/m 2 and 34% of those with BMI≥25 kg/m 2. Sarcopenic patients were older and less frequently African-American. Symptom burden did not differ among patients classified according to BMI and presence of sarcopenia. Median (95% confidence interval) survival (days) varied according to body composition: 215 (71-358) (BMI<25 kg/m 2; sarcopenic), 271 (99-443) (BMI<25 kg/m 2; non-sarcopenic), 484 (286-681) (BMI≥25 kg/m 2; sarcopenic); 501 d (309-693) (BMI≥25 kg/m 2; non-sarcopenic). Higher muscle index and gastrointestinal cancer diagnosis predicted longer survival in multivariate analysis after controlling for age, gender, performance status, and fat index. Conclusions: Patients referred to a Phase I clinic had a high frequency of sarcopenia and a BMI≥25 kg/m 2, independent of symptom burden. Body composition variables were predictive of clinically relevant survival differences, which is potentially important in developing Phase I studies.
AB - Background: Body weight and body composition are relevant to the outcomes of cancer and antineoplastic therapy. However, their role in Phase I clinical trial patients is unknown. Methods: We reviewed symptom burden, body composition, and survival in 104 patients with advanced cancer referred to a Phase I oncology service. Symptom burden was analyzed using the MD Anderson Symptom Assessment Inventory(MDASI); body composition was evaluated utilizing computerized tomography(CT) images. A body mass index (BMI)≥25 kg/m 2 was considered overweight. Sarcopenia, severe muscle depletion, was assessed using CT-based criteria. Results: Most patients were overweight (n = 65, 63%); 53 patients were sarcopenic (51%), including 79% of patients with a BMI<25 kg/m 2 and 34% of those with BMI≥25 kg/m 2. Sarcopenic patients were older and less frequently African-American. Symptom burden did not differ among patients classified according to BMI and presence of sarcopenia. Median (95% confidence interval) survival (days) varied according to body composition: 215 (71-358) (BMI<25 kg/m 2; sarcopenic), 271 (99-443) (BMI<25 kg/m 2; non-sarcopenic), 484 (286-681) (BMI≥25 kg/m 2; sarcopenic); 501 d (309-693) (BMI≥25 kg/m 2; non-sarcopenic). Higher muscle index and gastrointestinal cancer diagnosis predicted longer survival in multivariate analysis after controlling for age, gender, performance status, and fat index. Conclusions: Patients referred to a Phase I clinic had a high frequency of sarcopenia and a BMI≥25 kg/m 2, independent of symptom burden. Body composition variables were predictive of clinically relevant survival differences, which is potentially important in developing Phase I studies.
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U2 - 10.1371/journal.pone.0029330
DO - 10.1371/journal.pone.0029330
M3 - Review article
C2 - 22235285
AN - SCOPUS:84855318187
SN - 1932-6203
VL - 7
JO - PloS one
JF - PloS one
IS - 1
M1 - e29330
ER -