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PLoS One. 2012;7(1):e29330. doi: 10.1371/journal.pone.0029330. Epub 2012 Jan 3.

Body composition, symptoms, and survival in advanced cancer patients referred to a phase I service.

Author information

1
Department of Investigational Cancer Therapeutics (A Phase I Clinical Trials Program), The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.

Abstract

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/m² 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/m² and 34% of those with BMI≥25 kg/m². 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/m²; sarcopenic), 271 (99-443) (BMI<25 kg/m²; non-sarcopenic), 484 (286-681) (BMI≥25 kg/m²; sarcopenic); 501 d (309-693) (BMI≥25 kg/m²; 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/m², independent of symptom burden. Body composition variables were predictive of clinically relevant survival differences, which is potentially important in developing Phase I studies.

PMID:
22235285
PMCID:
PMC3250428
DOI:
10.1371/journal.pone.0029330
[Indexed for MEDLINE]
Free PMC Article

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