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Background: Systemic inflammation is crucial in cancer cachexia, but the optimal measurement method remainsunclear. This study compares markers of systemic inflammation (MoSI) in predicting weight loss in patients withmetastatic cancer.Methods: This prospective, observational multi-center study involved patients undergoing radiotherapy forbone metastases. Baseline assessments included demographics, clinical characteristics, previous weight loss,and appetite loss. MoSI included: C-reactive protein (CRP), albumin, white blood cells, neutrophil-to-lymphocyteratio, monocyte-to-lymphocyte ratio, interleukin-6 (IL-6), modified Glasgow Prognostic Score (mGPS), andPrognostic Nutritional Index. Body weight was recorded at baseline, 3, and 8 weeks post-radiotherapy. Multiplelinear regression assessed MoSI’s predictive ability for weight loss, adjusting for previous weight loss, appetiteloss, and primary tumour type. Goodness-of-fit was assessed using adjusted R2.Results: Out of 574 recruited patients, 540 and 470 were analyzed at 3 and 8 weeks, respectively. The median age(IQR) was 67 (15), 330 (61%) were male, and 397 (74%) had a Karnofsky performance status ≥70. In a base modelwithout MoSI, significant predictors of weight loss at 3 weeks were appetite loss and urological, lung, and gastrointestinalcancer (adjusted R2 of 0.064), while at 8 weeks, urological and lung cancer were significant (adjusted R2of 0.035). At 3 weeks, all MoSI significantly improved the base model, with adjusted R2 between 0.078 and 0.091.At 8 weeks: CRP, mGPS, albumin and IL-6 improved the model; however only CRP and mGPS retained an adjustedR2 of ~0.09.Conclusions: All MoSI predicted weight loss, but CRP and mGPS were the most optimal.
Vagnildhaug et al. (Mon,) studied this question.
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