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- W2973191010 abstract "Sarcopenia has been associated with poor survival across a heterogeneous group of diseases, including malignancy. Normalized total psoas area (NTPA) has been used as a surrogate for defining sarcopenia in clinical studies. Few data exist characterizing the effect of sarcopenia utilizing (NTPA) in patients with early stage, node-negative, non-small cell lung cancer treated with SBRT. Our aim was to assess the association of sarcopenia utilizing NTPA as a surrogate on overall survival and progression free survival in a diverse group of early stage, node negative, NSCLC patients treated with SBRT. A retrospective analysis of eligible patients treated with SBRT from 2013 to 2019 was conducted. Clinical variables of interest, including overall survival (OS), local failure free survival, distant failure free survival, normalized total psoas area (NTPA), BMI and Charlson Co-morbidity index (CCMI), were abstracted from the electronic medical record for analysis. NTPA was calculated by measuring the psoas volume at the L3 vertebra and normalizing for patient height. Measurements were performed on pre-SBRT imaging in PACS using the measurement tool. Survival functions were evaluated using the Kaplan-Meier method. Log-rank test and Cox-proportional hazards were performed for categorical and continuous variables, respectively. Significance was set as p < 0.05. 91 patients met criteria and were included in the current analysis. Patients had a median age of 76 and median KPS score of 80 (range: 60-100). 55% of patients were female and 79% of patients had T1 tumors. Median radiation dose and number of fractions were 60 Gy (range: 45-60) and 5 fractions (range: 2-12) respectively. Median NTPA was 531.16 mm2/m2 (range: 90.4-1356.2). Based on sex and height adjusted values (Sarcopenia= <385mm2/m2- female, <585 mm2/m2-male), 39 patients (42.8%) had sarcopenia. In the entire cohort, higher CCMI scores were associated with worse local failure free (HR 1.2, 95% CI 1.1-1.4) and progression free survival (HR 1.3, 95% CI 1.1-1.5) while increasing BMI was associated with better OS (HR 0.90, 95% CI .83-.98). NTPA had no association with OS (p=0.7), local FFS (p= 0.9) or distant FFS (p= 0.5). With a median follow-up of 23.4 months, median OS was 60 , 60 and 45.9 months (p=0.37) in all patients, non-sarcopenic and sarcopenic patients, respectively. Sarcopenia, using normalized total psoas area as a surrogate, was not associated with overall survival or local failure free survival in patients with early stage NSCLC treated with SBRT. However, in the entire cohort, higher CCMI scores were associated with worse LFFS and DFFS. Higher BMI appears to be associated with improved OS. Future work is needed to define the role of using surrogates such as NTPA over other metrics such as BMI/CCMI in defining deconditioned high-risk patient populations. Additional future work is needed to further define the impact of sarcopenia on cancer patients treated with SBRT." @default.
- W2973191010 created "2019-09-19" @default.
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- W2973191010 date "2019-09-01" @default.
- W2973191010 modified "2023-10-01" @default.
- W2973191010 title "Impact of Sarcopenia Using Normalized Total Psoas Area as a Surrogate on Overall Survival and Recurrence in Early Stage NSCLC Patients Treated with Stereotactic Body Radiotherapy" @default.
- W2973191010 doi "https://doi.org/10.1016/j.ijrobp.2019.06.2446" @default.
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