Deterioration in Muscle Mass and Physical Function Differs According to Weight Loss History in Cancer Cachexia.

Autor:	Stene GB; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Cancer Clinic, Trondheim University Hospital, 7491 Trondheim, Norway., Balstad TR; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Cancer Clinic, Trondheim University Hospital, 7491 Trondheim, Norway., Leer ASM; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway., Bye A; Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, 0167 Oslo, Norway.; Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, 0167 Oslo, Norway., Kaasa S; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Cancer Clinic, Trondheim University Hospital, 7491 Trondheim, Norway.; European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, 0167 Oslo, Norway., Fallon M; Edinburgh Cancer Research Centre, University of Edinburgh, Crewe Road, Edinburgh EH4 2XR, UK., Laird B; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XR, UK.; St Columba's Hospice, Boswall Road, Edinburgh EH4 2XR, UK., Maddocks M; Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, Bessemer Road, London SE5 9PJ, UK., Solheim TS; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology, 7491 Trondheim, Norway.; Cancer Clinic, Trondheim University Hospital, 7491 Trondheim, Norway.
Jazyk:	angličtina
Zdroj:	Cancers [Cancers (Basel)] 2019 Dec 03; Vol. 11 (12). Date of Electronic Publication: 2019 Dec 03.
DOI:	10.3390/cancers11121925
Abstrakt:	Background: Muscle mass and physical function (PF) are common co-primary endpoints in cancer cachexia trials, but there is a lack of data on how these outcomes interact over time. The aim of this secondary analysis of data from a trial investigating multimodal intervention for cancer cachexia (ClinicalTrials.gov: NCT01419145) is to explore whether changes in muscle mass and PF are associated with weight loss and cachexia status at baseline. Methods: Secondary analysis was conducted using data from a phase II randomized controlled trial including 46 patients with stage III-IV non-small cell lung cancer (n = 26) or inoperable pancreatic cancer (n = 20) due to commence chemotherapy. Cachexia status at baseline was classified according to international consensus. Muscle mass (assessed using computed tomography (CT)) and PF outcomes, i.e., Karnofsky performance status (KPS), self-reported PF (self-PF), handgrip strength (HGS), 6-minute walk test (6MWT), and physical activity (PA), were measured at baseline and after six weeks. Results: When compared according to cachexia status at baseline, patients with no/pre-cachexia had a mean loss of muscle mass (-5.3 cm 2 , p = 0.020) but no statistically significant change in PF outcomes. Patients with cachexia also lost muscle mass but to a lesser extent (-2.8 cm 2 , p = 0.146), but demonstrated a statistically significant decline in PF; KPS (-3.8 points, p = 0.030), self-PF (-8.8 points, p = 0.027), and HGS (-2.7 kg, p = 0.026). Conclusions: Weight loss history and cachexia status at baseline are of importance if one aims to detect changes in PF outcomes in cancer cachexia trials. To improve the use of co-primary endpoints that include PF in future trials, outcomes that have the potential to detect change relative to weight loss should be investigated further.
Databáze:	MEDLINE
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