随着癌症治疗过程中骨骼肌(SM)和脂肪组织(AT)变化对患者结果影响的认识不断加深，研究人员越来越多地对其进行测量。最近的荟萃分析报道了这一领域的高异质性，反映了结果估计中的不确定性。以姑息化疗为例，我们的目标是系统总结评估癌症治疗过程中骨骼肌和脂肪组织变化的研究之间的变异源，并提出未来研究的标准，以便进行可靠的荟萃分析。纳入在实体肿瘤姑息化疗过程中对成年患者的计算机断层扫描测定的骨骼肌和/或脂肪组织变化的研究，没有日期或地区限制。通过摘要/标题筛选的2496篇论文中，全文检阅了83篇，并提取了38篇进行分析，代表了8个肿瘤部位的34个独特队列。基线测量的时机通常定义为治疗之前，而终点时机从治疗开始后6周到进展时不等。不到50%的研究指明了实际测量时间间隔。不经常讨论测量误差(8/34)。在18/34个队列中，使用了单一指标(cm2 /m2 , cm2 或 %)来描述骨骼肌变化，而在10/34个队列中呈现了多个指标，而在6/34个队列中没有描述性指标。10/34个队列提供了脂肪组织变化指标和性别特定的报告。24篇文章评估了骨骼肌流失与总生存期的关联，骨骼肌丧失的分类范围从任何流失到>14%的流失，时间间隔变化。年龄和性别是最常见的共变量，50%的模型中涉及疾病反应。尽管有大量的数据和努力，但研究设计、报告和统计分析的异质性阻碍了骨骼肌和脂肪组织变化在癌症治疗中严重程度和结果上的证据综合。提议的研究设计标准包括选择同质队列、明确定义基线/终点时机和关注测量误差。标准报告应包括按性别的基线骨骼肌和脂肪组织、实际扫描间隔、多种指标描述的骨骼肌和脂肪组织变化，并可视化观察到的变化范围。性别报告将推进对骨骼肌和脂肪组织变化的性别二态性的理解。评估组织变化对结果的影响需要对相关共变量和并发疾病反应进行调整。研究人员和出版商采纳这些标准将改变当前的范式，使未来研究成为可能的荟萃分析，并推动领域朝向对临床护理应用骨骼肌和脂肪组织变化产生有意义的方式发展。© 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.

Investigators are increasingly measuring skeletal muscle (SM) and adipose tissue (AT) change during cancer treatment to understand impact on patient outcomes. Recent meta-analyses have reported high heterogeneity in this literature, representing uncertainty in the resulting estimates. Using the setting of palliative-intent chemotherapy as an exemplar, we aimed to systematically summarize the sources of variability among studies evaluating SM and AT change during cancer treatment and propose standards for future studies to enable reliable meta-analysis. Studies that measured computed tomography-defined SM and/or AT change in adult patients during palliative-intent chemotherapy for solid tumours were included, with no date or geographical limiters. Of 2496 publications screened by abstract/title, 83 were reviewed in full text and 38 included for extraction, representing 34 unique cohorts across 8 tumour sites. The timing of baseline measurement was frequently defined as prior to treatment, while endpoint timing ranged from 6 weeks after treatment start to time of progression. Fewer than 50% specified the actual time interval between measurements. Measurement error was infrequently discussed (8/34). A single metric (cm2 /m2 , cm2 or %) was used to describe SM change in 18/34 cohorts, while multiple metrics were presented for 10/34 and no descriptive metrics for 6/34. AT change metrics and sex-specific reporting were available for 10/34 cohorts. Associations between SM loss and overall survival were evaluated in 24 publications, with classification of SM loss ranging from any loss to >14% loss over variable time intervals. Age and sex were the most common covariates, with disease response in 50% of models. Despite a wealth of data and effort, heterogeneity in study design, reporting and statistical analysis hinders evidence synthesis regarding the severity and outcomes of SM and AT change during cancer treatment. Proposed standards for study design include selection of homogenous cohorts, clear definition of baseline/endpoint timing and attention to measurement error. Standard reporting should include baseline SM and AT by sex, actual scan interval, SM and AT change using multiple metrics and visualization of the range of change observed. Reporting by sex would advance understanding of sexual dimorphism in SM and AT change. Evaluating the impact of tissue change on outcomes requires adjustment for relevant covariates and concurrent disease response. Adoption of these standards by researchers and publishers would alter the current paradigm to enable meta-analysis of future studies and move the field towards meaningful application of SM and AT change to clinical care.© 2023 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by Wiley Periodicals LLC.