本研究的主要目的是评估现实世界中两组未经治疗的晚期非小细胞肺癌 (NSCLC) 患者身体成分增加的频率及其与体重变化的关系。一组接受当前的护理标准 (CSOC)，其中包括免疫疗法和较新的化疗方案，另一组接受以前的护理标准 (FSOC)，仅包括较旧的含铂方案。CSOC (n =本研究纳入了晚期 NSCLC 患者 (n = 106) 和 FSOC (n = 88) 队列。每次临床就诊时都会收集体重，并通过自动分割软件对常规胸部计算机断层扫描进行身体成分分析，并在基线、第 6 周和第 12 周时进行评估。使用标准统计方法来计算体重和身体成分变化之间的关系。CSOC队列包含106名在2014年12月16日至2020年10月22日期间接受治疗的IV期NSCLC患者，而FSOC队列包含88名III/IV期NSCLC患者2006年6月16日至2014年11月18日期间接受治疗的患者。虽然每个队列在第 6 周和第 12 周的时间点都表现出中位体重、体重指数 (BMI)、平均骨骼肌指数 (SMI) 和皮下脂肪组织指数 (SATI) 的下降，但一部分患者的这些参数却有所增加。使用第 12 周时间点体重、BMI、SMI 和 SATI 增加 ≥2.5% 的阈值，两个队列在这些参数上显示出相似的增加（20.5% 和 27.3%）。以 12 周随访时增加 ≥5% 为切入点，8.0% 至 25.0% 的患者体重、BMI、SMI 和 SATI 增加 ≥5%。比较每个队列的这些结果没有发现显着差异。与第 6 周和第 12 周时 SMI 和 SATI 变化相关的体重变化 Pearson 系数范围为 0.31 至 0.58，所有 P 值均 < 0.02。 12 周体重变化与 VATI 和 IMATI 变化相关的皮尔逊系数范围为 0.26 至 0.47，所有 P 值均 < 0.05。每个队列的皮尔逊系数比较没有显示显着差异。尽管两个队列中均观察到中位体重、BMI、SMI 和 SATI 下降，但每个队列中经历这些参数增加的患者比例相似。这些发现，加上体重、肌肉质量和脂肪组织的纵向测量之间的正相关性，表明这些患者的体重增加涉及肌肉质量和脂肪组织的增加。经过验证，这些发现可能对癌症恶病质的临床试验设计和转化研究产生影响。© 2024 作者。 《恶病质、肌肉减少症和肌肉杂志》由 Wiley periodicals LLC 出版。

The primary objective of this study was to assess the frequency of body composition increases and their relationships to changes in body weight in two cohorts of real world, treatment-naïve, advanced non-small cell lung cancer (NSCLC) patients. One cohort received the current standard of care (CSOC), which consisted of immunotherapy and newer chemotherapy regimens, and the other cohort was treated with the former standard of care (FSOC), consisting only of older platinum-containing regimens.CSOC (n = 106) and FSOC (n = 88) cohorts of advanced NSCLC patients were included in this study. Weights were collected at each clinical visit, and body composition analysis from routine chest computed tomography via automated segmentation software assessed at baseline and at 6 and 12 weeks. Standard statistical methods were used to calculate relationships between changes in weight and in body composition.The CSOC cohort contained 106 stage IV NSCLC patients treated between 16/12/2014 and 22/10/2020 while the FSOC cohort contained 88 stage III/IV NSCLC patients treated between 16/6/2006 and 18/11/2014. While each cohort exhibited decreases in median weight, body mass index (BMI), mean skeletal muscle index (SMI) and subcutaneous adipose tissue index (SATI) at the 6 and 12 week time points, a subset of patients experienced increases in these parameters. Using a threshold of ≥2.5% increase for weight, BMI, SMI, and SATI at the 12 week time point, both cohorts showed similar (20.5% and 27.3%) increases in these parameters. With a cut point of ≥5% increase at 12 weeks follow-up, 8.0% to 25.0% of the patients gained ≥5% in weight, BMI, SMI and SATI. Comparing these results in each cohort showed no significant differences. Pearson coefficients for weight change related to changes in SMI and SATI at 6 and 12 weeks ranged from 0.31 to 0.58 with all P values <0.02. Pearson coefficients for weight change at 12 weeks related to changes in VATI and IMATI ranged from 0.26 to 0.47 with all P values <0.05. Comparison of Pearson coefficients for each cohort showed no significant differences.Although decreases in median weight, BMI, SMI and SATI were observed in both cohorts, similar percentage of patients in each cohort experienced increases in these parameters. These findings, plus the positive correlations between longitudinal measurements of weight, muscle mass and adipose tissue, indicate that weight gain in these patients involves increases in both muscle mass and adipose tissue. Upon validation, these findings could have implications for clinical trial design and for translational research in cancer cachexia.© 2024 The Author(s). Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.