Dataset Information

Association of Underweight and Weight Loss With Poor Prognosis and Poor Therapy Effectiveness in Brain Metastases: A Retrospective Study.

ABSTRACT:

Background

The prognostic role of body mass index (BMI) in patients with brain metastases is controversial. We aim to investigate the impact of BMI on prognosis and anti-cancer therapy effectiveness in brain metastases.

Methods

Patients diagnosed with brain metastases between Oct 2010 and July 2019 were followed for mortality through April 2021. The prognostic role of BMI on overall survival was assessed by a restricted cubic spline (RCS) using a flexible model to visualize the relationship between the BMI values and hazard ratios of all-cause mortality, followed by a cox regression model. The disparity of survival outcomes in patients receiving anti-cancer therapies or those did not was evaluated according to the classification of BMI.

Results

A total of 2,466 patients were included in the analysis, including 241 in the underweight (BMI < 18.5 kg/m²) group, 1,503 in the normal weight group (BMI 18.5-23.9 kg/m²), and 722 in the overweight (BMI ≥ 24 kg/m²) group. Relative to the normal weight group, underweight patients were associated with poor prognosis (adjusted HR 1.25, 95% CI 1.07-1.46, p = 0.005). However, those in the overweight group showed similar overall survival when compared to the normal-weight group. Patients with weight loss were associated with a higher risk of mortality compared with patients without significant weight loss. In underweight patients, there was an insignificant difference in survival outcomes whether they received anti-cancer therapies or not.

Conclusion

Underweight and significant weight loss were associated with poor prognosis in brain metastases. Meanwhile, anti-cancer therapies did not significantly improve overall survival in patients with underweight. These findings suggest that improving nutrition to maintain body weight is critical for patients with brain metastases.

SUBMITTER: He Y

PROVIDER: S-EPMC9286517 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Association of Underweight and Weight Loss With Poor Prognosis and Poor Therapy Effectiveness in Brain Metastases: A Retrospective Study.

He Yan Y Zhang Yu Y Chong Weelic W Pei Yiyan Y Zhang Renjie R Liu Zheran Z Yu Jiayi J Peng Xingchen X Fang Fang F

Frontiers in nutrition 20220701

<h4>Background</h4>The prognostic role of body mass index (BMI) in patients with brain metastases is controversial. We aim to investigate the impact of BMI on prognosis and anti-cancer therapy effectiveness in brain metastases.<h4>Methods</h4>Patients diagnosed with brain metastases between Oct 2010 and July 2019 were followed for mortality through April 2021. The prognostic role of BMI on overall survival was assessed by a restricted cubic spline (RCS) using a flexible model to visualize the re ...[more]

PMID: 35845778

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Project description:PurposeWhole brain radiation therapy (WBRT) remains the standard of care for patients with multiple brain metastases, but more than half of treated patients will develop intracranial progression. Because there is no clear consensus on the optimal therapeutic approach, a prognostic index would be helpful to guide treatment options at progression. We explored whether the recursive partitioning analysis (RPA) score prior to repeat WBRT is predictive of survival.Methods and materialsThis multi-institutional pooled analysis included patients with 2 or more brain metastases from any solid primary tumor that was treated with 2 courses of WBRT. Information on demographics, disease characteristics, and intervals between courses was collected. RPA class was abstracted or retrospectively assigned, and descriptive statistics calculated. Median survival (MS) was determined using the Kaplan-Meier method and compared using log rank tests. Univariate and multivariate analyses were performed via Cox regression analysis.ResultsFor 205 patients, the median age was 55 years (range, 25-83 years), 68% were female, 40.5% had non-small cell lung cancer, and 31.2% had small cell lung cancer. Prior to the second WBRT, 4.9% of patients were RPA class 1, 36.6% were RPA2, and 58.5% were RPA3, with an MS of 7.5 months (95% confidence interval [CI], 4.7-10.3), 5.2 months (95% CI, 3.7-6.7 months), and 2.9 months (95% CI, 2.2-2.9 months), respectively (P = .001). On univariate and multivariate analyses, a Karnofsky Performance Status of <80, extracranial metastases, interval between courses <9 months, small cell lung cancer histology, and uncontrolled primary significantly correlated with shorter MS. By assigning a score of 1 to each of these factors, a new prognostic index was created, the reirradiation (ReRT) score. Survival on the basis of ReRT score grouping ranged from 2.2 to 7.2 months and demonstrated significant differences in MS.ConclusionsIn the largest reported cohort to receive repeat WBRT, application of the RPA score was not predictive of MS. The new ReRT score is a simple tool based on readily available clinical information.

Dataset Information

Association of Underweight and Weight Loss With Poor Prognosis and Poor Therapy Effectiveness in Brain Metastases: A Retrospective Study.

Background

Methods

Results

Conclusion

Publications

Association of Underweight and Weight Loss With Poor Prognosis and Poor Therapy Effectiveness in Brain Metastases: A Retrospective Study.

Similar Datasets

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