在第三腰椎 (L3) 水平测量的肌肉减少症已被证明可以预测癌症患者的生存率。然而，许多晚期非小细胞肺癌 (NSCLC) 患者并未接受常规腹部影像学检查。本研究的目的是调查接受非小细胞肺癌免疫治疗的患者胸部肌肉减少症与生存结果的关系。在这项回顾性研究中，纳入了2019年至2022年开始接受晚期非小细胞肺癌免疫治疗的患者。并收集了详细的患者数据。根据治疗前胸部计算机断层扫描 (CT) 扫描计算第五胸椎 (T5) 的横截面骨骼肌面积。使用特定性别的最低四分位数值来定义肌肉减少症。使用 Cox 分析对危险因素进行分析。使用对数秩检验和随机生存森林（RSF）来比较无进展生存期（PFS）。使用校准曲线和受试者工作特征曲线 (ROC) 评估模型的性能。总共纳入 242 名患者（发现队列 n = 194，验证队列 n = 48）。在发现队列中，患有肌肉减少症的患者表现出比没有肌肉减少症的患者显着较差的 PFS (p < 0.001)。单变量 cox 回归显示，肌肉减少症、肺癌分期、体重指数、吸烟状况和中性粒细胞与淋巴细胞比率是不良 PFS 的预测因素。基于上述参数构建RSF模型，利用ROC曲线评价模型的有效性。预测 6 个月 PFS 的曲线下面积为 0.68，预测 12 个月 PFS 的曲线下面积为 0.69。发现队列建立的生存结果预测模型在验证队列中显示出相似的性能。T5 肌少症是接受晚期 NSCLC 免疫治疗的患者的独立预后因素。版权所有 © 2024 大学放射科医生协会。由爱思唯尔公司出版。保留所有权利。

Sarcopenia, as measured at the level of the third lumbar (L3) has been shown to predict the survival of cancer patients. However, many patients with advanced non-small cell lung cancer (NSCLC) do not undergo routine abdominal imaging. The objective of this study was to investigate the association of thoracic sarcopenia with survival outcomes among patients who underwent immunotherapy for NSCLC.In this retrospective study, patients who initiated immunotherapy for advanced NSCLC from 2019 to 2022 were enrolled. and detailed patient data were collected. Cross sectional skeletal muscle area was calculated at the fifth thoracic vertebra (T5) on pretreatment chest computed tomography (CT) scan. Gender-specific lowest quartile values was used to define sarcopenia. The risk factors were analyzed using Cox analyses. The log-rank test and the random survival forest (RSF) were used to compare progression free survival (PFS). The model's performance was assessed using calibration curve and the receiver operating characteristic curve (ROC).A total of 242 patients was included (discovery cohort n = 194, validation cohort n = 48). In the discovery cohort, patients with sarcopenia exhibited significantly poorer PFS (p < 0.001) than patients without sarcopenia. Univariate cox regression revealed that sarcopenia, lung cancer stage, body mass index, smoking status, and neutrophil-to-lymphocyte ratio were predictors of poor PFS. A RSF model was constructed based on the aforementioned parameters, to evaluate the model's efficacy, the ROC curve was utilized. with an area under the curve for predicting 6-month PFS of 0.68 and for 12-month PFS of 0.69. The prediction models for survival outcomes built by the discovery cohort showed similar performance in the validation cohort.Sarcopenia at T5 is independent prognostic factors in patients who received immunotherapy for advanced NSCLC.Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.