Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer

ABSTRACT Background Cachexia is a syndrome in patients with cancer that reduces life quality and prognosis, characterized by severe weight loss, muscle atrophy, and anorexia. How cachexia adversely affects older patients with small cell lung cancer (SCLC) remains uncertain. This study aimed to deter...

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Main Authors: Michitoshi Yabe, Tateaki Naito, Suguru Matsuda, Meiko Morita, Motoki Sekikawa, Keita Miura, Hiroaki Kodama, Toshiya Fujisaki, Nobuaki Mamesaya, Haruki Kobayashi, Ryo Ko, Kazushige Wakuda, Akira Ono, Hirotsugu Kenmotsu, Haruyasu Murakami, Toshiaki Takahashi
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Thoracic Cancer
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Online Access:https://doi.org/10.1111/1759-7714.70104
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author Michitoshi Yabe
Tateaki Naito
Suguru Matsuda
Meiko Morita
Motoki Sekikawa
Keita Miura
Hiroaki Kodama
Toshiya Fujisaki
Nobuaki Mamesaya
Haruki Kobayashi
Ryo Ko
Kazushige Wakuda
Akira Ono
Hirotsugu Kenmotsu
Haruyasu Murakami
Toshiaki Takahashi
author_facet Michitoshi Yabe
Tateaki Naito
Suguru Matsuda
Meiko Morita
Motoki Sekikawa
Keita Miura
Hiroaki Kodama
Toshiya Fujisaki
Nobuaki Mamesaya
Haruki Kobayashi
Ryo Ko
Kazushige Wakuda
Akira Ono
Hirotsugu Kenmotsu
Haruyasu Murakami
Toshiaki Takahashi
author_sort Michitoshi Yabe
collection DOAJ
description ABSTRACT Background Cachexia is a syndrome in patients with cancer that reduces life quality and prognosis, characterized by severe weight loss, muscle atrophy, and anorexia. How cachexia adversely affects older patients with small cell lung cancer (SCLC) remains uncertain. This study aimed to determine the effect of cachexia on prognosis, treatment delivery, and efficacy in older patients with advanced SCLC receiving first‐line platinum‐based chemotherapy. Method We retrospectively analyzed older patients (≥ 70 years) with advanced SCLC treated with carboplatin and etoposide between January 2015 and June 2020 at the Shizuoka Cancer Center. Cachexia was diagnosed based on the % weight loss and body mass index. After excluding patients with no documented weight change and those who relapsed after radiotherapy, we examined the effect of cachexia on treatment delivery, progression‐free survival (PFS), and overall survival (OS). Results Cachexia was identified in 57% (28 of 49) of patients. The cachexia group experienced more frequent treatment interruptions and dose reductions than the non‐cachexia group (46% vs. 10% for dose reductions, p < 0.05; 61% vs. 90% for completion of four chemotherapy courses, p < 0.05). Median PFS and OS were significantly shorter in the cachexia group compared to those in the non‐cachexia group (PFS: 3.3 vs. 5.4 months; OS: 6.3 vs. 15.1 months). Conclusion Older patients with advanced SCLC and cachexia undergoing carboplatin and etoposide therapy exhibited shorter PFS and OS than those without cachexia. Treatment delivery was less effective in the cachexia group than in the non‐cachexia group, suggesting that their vulnerabilities affected treatment efficacy.
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spelling doaj-art-3e6a2c62b23846cf855d840afe8ab0b72025-08-20T02:48:30ZengWileyThoracic Cancer1759-77061759-77142025-06-011612n/an/a10.1111/1759-7714.70104Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung CancerMichitoshi Yabe0Tateaki Naito1Suguru Matsuda2Meiko Morita3Motoki Sekikawa4Keita Miura5Hiroaki Kodama6Toshiya Fujisaki7Nobuaki Mamesaya8Haruki Kobayashi9Ryo Ko10Kazushige Wakuda11Akira Ono12Hirotsugu Kenmotsu13Haruyasu Murakami14Toshiaki Takahashi15Division of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanDivision of Thoracic Oncology Shizuoka Cancer Center Shizuoka JapanABSTRACT Background Cachexia is a syndrome in patients with cancer that reduces life quality and prognosis, characterized by severe weight loss, muscle atrophy, and anorexia. How cachexia adversely affects older patients with small cell lung cancer (SCLC) remains uncertain. This study aimed to determine the effect of cachexia on prognosis, treatment delivery, and efficacy in older patients with advanced SCLC receiving first‐line platinum‐based chemotherapy. Method We retrospectively analyzed older patients (≥ 70 years) with advanced SCLC treated with carboplatin and etoposide between January 2015 and June 2020 at the Shizuoka Cancer Center. Cachexia was diagnosed based on the % weight loss and body mass index. After excluding patients with no documented weight change and those who relapsed after radiotherapy, we examined the effect of cachexia on treatment delivery, progression‐free survival (PFS), and overall survival (OS). Results Cachexia was identified in 57% (28 of 49) of patients. The cachexia group experienced more frequent treatment interruptions and dose reductions than the non‐cachexia group (46% vs. 10% for dose reductions, p < 0.05; 61% vs. 90% for completion of four chemotherapy courses, p < 0.05). Median PFS and OS were significantly shorter in the cachexia group compared to those in the non‐cachexia group (PFS: 3.3 vs. 5.4 months; OS: 6.3 vs. 15.1 months). Conclusion Older patients with advanced SCLC and cachexia undergoing carboplatin and etoposide therapy exhibited shorter PFS and OS than those without cachexia. Treatment delivery was less effective in the cachexia group than in the non‐cachexia group, suggesting that their vulnerabilities affected treatment efficacy.https://doi.org/10.1111/1759-7714.70104cachexiacarboplatinetoposideprognosissmall cell lung carcinoma
spellingShingle Michitoshi Yabe
Tateaki Naito
Suguru Matsuda
Meiko Morita
Motoki Sekikawa
Keita Miura
Hiroaki Kodama
Toshiya Fujisaki
Nobuaki Mamesaya
Haruki Kobayashi
Ryo Ko
Kazushige Wakuda
Akira Ono
Hirotsugu Kenmotsu
Haruyasu Murakami
Toshiaki Takahashi
Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer
Thoracic Cancer
cachexia
carboplatin
etoposide
prognosis
small cell lung carcinoma
title Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer
title_full Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer
title_fullStr Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer
title_full_unstemmed Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer
title_short Effect of Cancer Cachexia on the Efficacy and Treatment Delivery of Chemotherapy in Older Patients With Advanced Small Cell Lung Cancer
title_sort effect of cancer cachexia on the efficacy and treatment delivery of chemotherapy in older patients with advanced small cell lung cancer
topic cachexia
carboplatin
etoposide
prognosis
small cell lung carcinoma
url https://doi.org/10.1111/1759-7714.70104
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