Table 5. Studies describing the association of radiotherapy outcomes with various obesity measures.
| Study | Sample size | Obesity measure | Results | Comment |
|---|---|---|---|---|
| Abbass et al., 2020 (99) | 643 | ECOG-PS†, mGPS‡, MUST§, SAT, SMD, SMI, VAT | Higher MUST (HR =1.16), ECOG-PS >1 (HR =1.23), and elevated mGPS (HR =1.2) were independently associated with worse OS | Malnutrition is associated with poor overall survival in patients with lung cancer |
| Burtin et al., 2020 (97) | 936 | FFM, handgrip weakness, WHO-PS | In patients with WHO-PS 0 or 1, low FFM combined with handgrip weakness predicted lower OS (HR =1.31, 95% CI: 1.07–1.59) | – |
| Dolan et al., 2020 (100) | 119 | ECOG-PS, mGPS, MUST, NLR, SMD, SMI, tumor glucose uptake, visceral obesity¶ | Higher MUST (HR =1.49, 95% CI: 1.12–1.98) and elevated tumor lesional glycolysis* (HR =2.02, 95% CI: 1.34–3.04) associated with worse OS | Total lesion glycolysis (tumor metabolic activity) and mGPS (systemic inflammatory response) were not associated with body composition |
| Willemsen et al., 2020 (96) | 233 | FM, FFM, handgrip strength, weight loss | FFMI and HGS <10th percentile baseline reference values were prognostic for poor OS (HR =1.64, 95% CI: 1.1–2.39). FM loss during CRT was also predictive of poor OS (HR =3.8, 95% CI: 1.79–8.06) | Weight loss was associated with loss of fat and FFM |
†, ECOG-PS includes muscle mass and function; ‡, mGPS reflects systemic inflammation and nutritional status and is a combination of C-reactive protein and albumin levels; §, MUST include weight loss, BMI, and nutritional intake; ¶, visceral obesity was measured as visceral fat area >160 and >80 cm2 in males and females respectively; *, tumor lesional glycolysis is a measure of tumor metabolic activity and glucose uptake. ECOG-PS, Eastern Cooperative Oncology Group-Performance Status; mGPS, modified Glasgow prognostic score; MUST, malnutrition universal screening tool; SAT, subcutaneous adipose tissue; SMD, skeletal muscle density; SMI, skeletal muscle index; VAT, visceral adipose tissue; HR, hazard ratio; OS, overall survival; FFM, fat free mass; WHO-PS, World Health Organization-Performance Status; CI, confidence interval; NLR, neutrophil to lymphocyte ratio; FM, fat mass; FFMI, fat free mass index; HGS, hand grip strength; CRT, chemoradiotherapy.