PMID- 33791917
OWN - NLM
STAT- MEDLINE
DCOM- 20210622
LR  - 20220927
IS  - 1437-7772 (Electronic)
IS  - 1341-9625 (Linking)
VI  - 26
IP  - 7
DP  - 2021 Jul
TI  - The impact of cachexia and sarcopenia in elderly pancreatic cancer patients 
      receiving palliative chemotherapy.
PG  - 1293-1303
LID - 10.1007/s10147-021-01912-0 [doi]
AB  - BACKGROUND: Elderly pancreatic cancer (PC) patients are often considered 
      vulnerable to treatment and standard treatment strategy for this subpopulation is 
      uncertain. Cachexia and sarcopenia are reported to be associated with reduced 
      physical performance, reduced anti-tumor response, increased chemotherapy 
      toxicity, and poor prognosis in several malignancies. The aim of this study was 
      to evaluate the impact of cachexia and sarcopenia on the clinical course of 
      elderly PC patients receiving chemotherapy. METHODS: We retrospectively 
      investigated consecutive elderly metastatic PC patients (>/= 75 years) treated with 
      chemotherapy at our institution between January 2015 and April 2020. Skeletal 
      muscle index was calculated at the third lumbar vertebra using pretreatment 
      computed tomography. We evaluated time to treatment failure (TTF), 
      progression-free survival (PFS), overall survival (OS), early treatment 
      discontinuation, relative dose intensity (RDI), and severe adverse events (AEs). 
      RESULTS: Among 80 patients included (gemcitabine plus nab-paclitaxel [GnP] 52; 
      gemcitabine 21; S1 6; modified FOLFIRINOX 1), cachexia and sarcopenia were 
      present in 48 (60%) and 61 (76%) patients, respectively. Cachexia was associated 
      with older age, worse performance status, higher level of neutrophil to 
      lymphocyte ratio, worse nutritional status, and shorter TTF and PFS. Furthermore, 
      it was also associated with early treatment discontinuation, reduced RDI of 
      nab-paclitaxel, and increased incidence of grade 4 neutropenia in patients 
      receiving GnP. On the other hand, sarcopenia had less impact on the clinical 
      course of elderly PC patients. CONCLUSIONS: In our experience, cachexia was 
      considered an effective tool in the management of elderly PC patients receiving 
      palliative chemotherapy.
FAU - Takeda, Tsuyoshi
AU  - Takeda T
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Sasaki, Takashi
AU  - Sasaki T
AUID- ORCID: 0000-0001-7109-9835
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan. sasakit-tky@umin.ac.jp.
FAU - Suzumori, Chisaki
AU  - Suzumori C
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Mie, Takafumi
AU  - Mie T
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Furukawa, Takaaki
AU  - Furukawa T
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Yamada, Yuto
AU  - Yamada Y
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Kasuga, Akiyoshi
AU  - Kasuga A
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Matsuyama, Masato
AU  - Matsuyama M
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Ozaka, Masato
AU  - Ozaka M
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
FAU - Sasahira, Naoki
AU  - Sasahira N
AD  - Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of 
      Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20210331
PL  - Japan
TA  - Int J Clin Oncol
JT  - International journal of clinical oncology
JID - 9616295
RN  - P88XT4IS4D (Paclitaxel)
SB  - IM
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
MH  - Cachexia/drug therapy/etiology
MH  - Humans
MH  - Paclitaxel/therapeutic use
MH  - *Pancreatic Neoplasms/complications/drug therapy
MH  - Retrospective Studies
MH  - *Sarcopenia/complications
OTO - NOTNLM
OT  - Cachexia
OT  - Elderly patients
OT  - Palliative chemotherapy
OT  - Pancreatic cancer
OT  - Sarcopenia
EDAT- 2021/04/02 06:00
MHDA- 2021/06/23 06:00
CRDT- 2021/04/01 06:41
PHST- 2021/01/29 00:00 [received]
PHST- 2021/03/24 00:00 [accepted]
PHST- 2021/04/02 06:00 [pubmed]
PHST- 2021/06/23 06:00 [medline]
PHST- 2021/04/01 06:41 [entrez]
AID - 10.1007/s10147-021-01912-0 [pii]
AID - 10.1007/s10147-021-01912-0 [doi]
PST - ppublish
SO  - Int J Clin Oncol. 2021 Jul;26(7):1293-1303. doi: 10.1007/s10147-021-01912-0. Epub 
      2021 Mar 31.