Abstract
OBJECTIVE: This study aimed to evaluate the association of cancer cachexia with psychosocial impact, nutrition impact symptoms (NIS), and geriatric assessment in older patients newly diagnosed with advanced lung cancer undergoing chemotherapy. METHODS: Older patients with advanced lung cancer scheduled to receive first-line chemotherapy between August 2021 and February 2022 were enrolled. Cachexia was diagnosed according to the International Consensus. NIS and psychosocial impacts were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ) C30, CAX24, and the Eating-Related Distress Questionnaire (ERD). Non-parametric tests evaluated the association between cachexia and its impacts. Patients with cachexia who consented to be interviewed were asked about their experiences with diet and weight changes. Three authors reviewed the interview data to ensure the analysis's veracity. RESULTS: Twenty-one of the 31 participants (68%) had cachexia at baseline. The cachexia group showed significantly greater severity of Food Aversion (P = 0.035), Eating and Weight Loss Worry (P < 0.001), and Loss of Control (P = 0.005) compared to the non-cachexia group. There were no significant differences in the ERD and geriatric assessment (all P > 0.05). The interview revealed that patients with cachexia perceived diet and weight changes early on and tried to manage their symptoms by themselves. CONCLUSIONS: Cancer cachexia showed an association with NIS and psychosocial impacts. Older patients with advanced lung cancer scheduled to receive first-line chemotherapy should undergo a comprehensive assessment of cancer cachexia, including its potential physical and psychological impacts. TRIAL REGISTRATION: The trial registration number was UMIN 000053843.