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CT-Derived Body Composition and Early Changes Predict Outcomes of First-Line Chemo-Immunotherapy in Recurrent/Metastatic Nasopharyngeal Carcinoma.

BackgroundReliable biomarkers for risk stratification and treatment monitoring in recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) treated with first-line chemo-immunotherapy remain limited. This study evaluated the prognostic value of baseline computed tomography (CT)-derived body compositio...

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Published in:Oncologist pp. 1 - 38
Main Authors: Gan, Xia, Yu, Zhengzheng, Tang, Yaning, Zhang, Lin, Xie, Wenji, Sun, Xiaowen, Li, Yue, Fang, Jianing, Liu, Yating, Liu, Zhongjie, Zhou, Can, Xie, Zhuolong, Yao, Wen, Ouyang, Shuyu, Zhang, Jing, Wang, Jingyu, Li, Hua, Chen, Pan, Wang, Hui, Li, Yanxian
Format: Journal Article
Published: Oxford University Press / USA Sep2026
Online Access:View this record in EBSCOhost
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        10837159
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      dt: Sep2026
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      pub: Oxford University Press / USA
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        197174067
        10.1093/oncolo/oyag355
        197174067
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        atl: CT-Derived Body Composition and Early Changes Predict Outcomes of First-Line Chemo-Immunotherapy in Recurrent/Metastatic Nasopharyngeal Carcinoma.
      aug:
        au:
          Gan, Xia
          Yu, Zhengzheng
          Tang, Yaning
          Zhang, Lin
          Xie, Wenji
          Sun, Xiaowen
          Li, Yue
          Fang, Jianing
          Liu, Yating
          Liu, Zhongjie
          Zhou, Can
          Xie, Zhuolong
          Yao, Wen
          Ouyang, Shuyu
          Zhang, Jing
          Wang, Jingyu
          Li, Hua
          Chen, Pan
          Wang, Hui
          Li, Yanxian
      sug:
      ab: BackgroundReliable biomarkers for risk stratification and treatment monitoring in recurrent/metastatic nasopharyngeal carcinoma (R/M NPC) treated with first-line chemo-immunotherapy remain limited. This study evaluated the prognostic value of baseline computed tomography (CT)-derived body composition parameters and their early dynamic changes.MethodsIn this single-center retrospective cohort study, patients with R/M NPC receiving first-line chemo-immunotherapy were included. The primary endpoint was progression-free survival (PFS), and secondary endpoints included overall survival (OS), objective response rate (ORR), and disease control rate (DCR). Associations between body composition and outcomes were analyzed.ResultsA total of 199 patients were included, and 99 with post-treatment CT after two cycles were further analyzed for dynamic changes. Higher baseline skeletal muscle area (SMA) was independently associated with longer PFS (HR = 0.56, 95% CI: 0.37-0.85, <italic>p</italic> = 0.006) and OS (HR = 0.46, 95% CI: 0.23-0.93, <italic>p</italic> = 0.03), and with higher ORR (82.8% vs 70.0%, <italic>p</italic> = 0.033) and DCR (98.0% vs 91.0%, <italic>p</italic> = 0.031). During early treatment, a ≤ 1.3% decrease or an increase in SMA was independently associated with longer PFS (HR = 0.53, <italic>p</italic> = 0.045) and OS (HR = 0.27, <italic>p</italic> = 0.018). A greater decline in visceral adipose tissue density (ΔVATD < -0.9%) was also associated with more favorable PFS and OS, whereas no significant difference in ORR was observed.ConclusionBaseline SMA and early changes in SMA and VATD have prognostic value in R/M NPC treated with first-line chemo-immunotherapy. CT-based body composition assessment may serve as a practical imaging biomarker for risk re-stratification and individualized management.Implications for PracticeCT-based body composition assessment may provide a practical approach for individualized management of patients with recurrent/metastatic nasopharyngeal carcinoma receiving chemo-immunotherapy. Incorporating body composition assessment into routine CT imaging analysis may further improve risk stratification and facilitate early identification of patients with poor prognosis. For patients with low skeletal muscle reserve or significant early muscle loss during treatment, timely nutritional assessment, exercise support, and closer clinical monitoring may be considered to optimize supportive care and treatment management.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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