Non-cancerous CT findings as predictors of survival outcome in advanced non-small cell lung cancer patients treated with first-generation EGFR-TKIs

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0313577 - e0313577

Published: Feb. 5, 2025

Purpose To identify non-cancerous factors from baseline CT chest affecting survival in advanced non-small cell lung cancer (NSCLC) treated with first-generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs). Methods Retrospective study of 172 NSCLC patients EGFR-TKIs as a first-line systemic treatment (January 2012 to September 2022). Baseline assessed visceral/subcutaneous fat (L1 level), sarcopenia, and myosteatosis (multiple levels), main pulmonary artery (MPA) size, MPA aorta ratio, emphysema, bone mineral density. Cox regression analyzed prognostic at 18-month outcome. Results Median overall was 17.57 months (14.87–20.10) 76 (44.19%) died 18 months. Deceased had lower BMI (21.10 ± 3.44) vs. survived (23.25 4.45) (p < 0.001). Univariable analysis showed 5 significant factors: low total adiposity with/without cutoff [HR 2.65 (1.68–4.18), p 0.001; 1.00 (0.99–1.00), = 0.006;], subcutaneous adipose tissue (SAT) 1.95 (1.23–3.11), 0.005; 0.99 (0.98–0.99), 0.005], SAT index (SATI) [1.74 (1.10–2.78), 0.019; 0.98 (0.97–0.99), 0.003], high VSR [1.67 (1.06–2.62), 0.026], size [2.23 (1.23–4.04), 1.09 (1.04–1.16), 0.001]. > 29 mm, ≤85 cm 2 remained multivariable analysis, adjusted by 1.14 (1.07–1.21), 3.10 (1.81–5.28), 3.91 (1.63–9.40), 0.002]. There no difference sarcopenic myosteatotic parameters between the two groups. Conclusion In EGFR-mutated patients, assessing pre-treatment prognosis is warranted predict outcome guide decision regarding EGFR-TKI therapy. Enlarged adiposity, (lower SAT, SATI, higher VSR) are indicators poor survival. Large (>29 mm) or (≤85 ) alone death.

Language: Английский

Prognostic Value of Sarcopenia in Elderly Patients with Metastatic Non-Small-Cell Lung Cancer Undergoing Radiotherapy

Current Oncology, Journal Year: 2024, Volume and Issue: 31(11), P. 6673 - 6685

Published: Oct. 25, 2024

Sarcopenia, a syndrome characterized by age-related loss of muscle mass and function, lacks universally accepted diagnostic criteria, particularly for its role as prognostic factor in elderly patients with non-small-cell lung cancer (NSCLC). This study aimed to evaluate the significance sarcopenia, assessed psoas size on baseline CT scans, over 70 years age metastatic NSCLC.

Language: Английский