Table 2.
Classification of endpoints in randomized controlled trials for patients with cachexia
| Endpoints | Total | Pre-CR group | Post-CR group |
|---|---|---|---|
| Publication year | 2003-2018 | 2003-2010 | 2011-2018 |
| Number of studies | 65 | 21 | 44 |
| Body mass, n (%) | |||
| Body weight or BMI | 49 (75) | 15 (71) | 34 (77) |
| Lean body massa | 31 (48) | 12 (57) | 19 (43) |
| Anthropometricsb | 6 (9) | 4 (19) | 2 (5) |
| Nutritional status, n (%) | |||
| Food intake | 23 (35) | 8 (38) | 15 (34) |
| Resting energy expenditurec | 9 (14) | 5 (24) | 4 (9) |
| Assessment toold | 8 (12) | 1 (5) | 7 (16) |
| Physical function, n (%) | |||
| Performance statuse | 19 (29) | 8 (38) | 11 (25) |
| Hand-grip strength | 15 (23) | 2 (10) | 13 (30) |
| Physical activityf | 7 (11) | 3 (14) | 4 (9) |
| Field walking testsg | 6 (9) | 2 (10) | 4 (9) |
| Performance testsh | 5 (8) | 0 | 5 (11) |
| Lower limb strengthi | 3 (5) | 1 (5) | 2 (5) |
| Cardiopulmonary exercise test | 2 (3) | 2 (10) | 0 |
| Symptoms, n (%) | |||
| Anorexiaj | 24 (37) | 11 (52) | 13 (30) |
| Fatiguek | 17 (26) | 4 (19) | 13 (30) |
| Psychosociall | 4 (6) | 1 (5) | 3 (7) |
| QOL, n (%) | |||
| Global scalem | 43 (66) | 16 (76) | 27 (61) |
| Specific modulen | 9 (14) | 0 | 9 (20) |
| Prognosis, n (%) | |||
| Overall survival | 21 (32) | 9 (43) | 12 (27) |
| Progression-free survival | 3 (5) | 1 (5) | 2 (5) |
| Use of medical resources, n (%) | |||
| Length of hospital stay | 3 (5) | 0 | 3 (7) |
| Medical cost | 1 (2) | 0 | 1 (2) |
| Cancer treatment, n (%) | |||
| Toxicity | 7 (11) | 3 (14) | 4 (9) |
| Treatment delivery | 5 (8) | 1 (5) | 4 (9) |
| Treatment efficacy | 4 (6) | 2 (10) | 2 (5) |
| Biomarkers, n (%) | |||
| Inflammatoryo | 25 (38) | 10 (48) | 15 (34) |
| Nutritionalp | 21 (32) | 6 (29) | 15 (34) |
| Metabolicq | 13 (20) | 5 (24) | 8 (18) |
| Endocrinologicalr | 5 (8) | 1 (5) | 4 (9) |
aLean body mass, fat-free mass, or lumbar skeletal muscle mass measured by dual-energy X-ray absorptiometry, bioelectrical impedance analysis, or computed tomography, bArm muscle area or triceps skinfold thickness, cMeasured or estimated by calorimetry or an accelerometer, dAssessed by PG-SGA or NRS-2002, eKarnofsky or Eastern Cooperative Oncology Group performance status, fMeasured by a pedometer/accelerometer or questionnaire, gAssessed by the 6-min walk test or shuttle walking test, hAssessed by the stair climb test, 30-s chair stand test, or 10-min walk speed test, iMuscle strength in knee flexors, knee extensors, or quadriceps, jAssessed by a visual analogue scale, symptom scale of the EORTC QLQ-Core 30 questionnaire, the National Central Cancer Treatment Group (NCCTG) anorexia questionnaire, or others, kAssessed by the FACIT-F, MFSI-SF, symptom scale of the EORTC QLQ-Core 30, BFI, or others, lAssessments for depression, anxiety, insomnia, or weight-/eating-related distress, mAssessed by the EORTC QLQ-Core 30, FAACT, EQ5D, or others, nAssessed by the EORTC QLQ-H and N35 (head and neck cancer module) or EORTC QLQ-PAN26 (pancreatic cancer module), FACT-L, or others, oNutritional biomarkers included serum albumin, prealbumin, transferrin, hemoglobin, lymphocyte count, and others, pInflammatory biomarkers included C-reactive protein, Glasgow prognostic score, cytokines and their receptors, and others, qMetabolic biomarkers included lipids, fatty acids, reactive oxygen species, bone metabolic markers, and others, rEndocrinological biomarkers included growth hormone, ghrelin, leptin, insulin-like growth factor 1, insulin-like growth factor-binding protein 3, and others. CR: Consensus report for cancer cachexia published in 2011, BMI: Body mass index, PG-SGA: Patientgenerated subjective global assessment, NRS: Nutritional risk screening, EORTC QLQ: European organisation for research and treatment of cancer QOL questionnaire, BFI: Brief fatigue inventory, FACIT-F: Functional assessment of chronic illness therapy-fatigue, FAACT: Functional assessment of anorexia/cachexia therapy, FACT-L: Functional assessment of cancer therapy-Lung, EQ5D: EuroQol 5-Dimension, MFSI-SF: Multidimensional fatigue symptom inventory-short form, QOL: Quality of life