Abstract

Background: Cancer cachexia is associated with reduced quality of life, tolerance to treatment modalities and survival. We aimed to determine the impact of cancer cachexia on the course of chemotherapy and the response to treatment in advanced lung cancer patients. Methods: A retrospective study including patients with advanced lung cancer followed between 2019 and 2021. Cancer cachexia was defined as body mass index (BMI ) < 20 kg/m² and  weight loss > 2% with reduced food intake. Two groups were compared: G1 (patients with cachexia, n=37) and G2 (patients without cachexia, n= 34). Results: Seventy one patients were included. The average age was 60 years. All patients were male. Ninety seven percent were smokers. Comorbidities were associated in 50%: COPD (23%), high blood pressure (12%), coronary insufficiency (8%), diabetes (4%) and respiratory failure (3%).  No correlation was observed between comorbidities and cancer cachexia (p=0.06). The most common histological types were: adenocarcinoma in 57%, small cell carcinoma in 16% and squamous cell carcinoma in 15% of cases. Cancer cachexia was associated with more number of chemotherapy cycles delayed: 75% in G1 vs 25% in G2 (p= 0.003). Patients with cancer cachexia had lower number of chemotherapy cycles completed, p=0.003. Progression after chemotherapy was most frequent in G1: 57%  vs  43% in G2 (p=0.004). Cancer cachexia was associated with the decision of palliative care after progression: 65% in G1 vs 34% in G 2 (p =0.005). Conclusion: Cancer cachexia is associated with poor tolerance to chemotherapy and more progression after treatment in patients with advanced lung cancer.