The association of pretreatment low skeletal muscle mass with chemotherapy dose-limiting toxicity in patients with head and neck cancer undergoing primary chemoradiotherapy with high-dose cisplatin

被引：15
|
作者：
Bril, Sandra, I [1 ]
Al-Mamgani, Abrahim [2 ]
Chargi, Najiba [1 ]
Remeijer, Peter [2 ]
Devriese, Lot A. [3 ]
de Boer, Jan Paul [4 ]
de Bree, Remco [1 ]
机构：
[1] Univ Med Ctr Utrecht, UMC Utrecht Canc Ctr, Dept Head & Neck Surg Oncol, Utrecht, Netherlands
[2] Netherlands Canc Inst Antoni van Leeuwenhoek, Dept Radiat Oncol, Amsterdam, Netherlands
[3] Univ Med Ctr Utrecht, UMC Utrecht Canc Ctr, Dept Med Oncol, Utrecht, Netherlands
[4] Netherlands Canc Inst Antoni van Leeuwenhoek, Dept Med Oncol, Amsterdam, Netherlands
来源：
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2022年 / 44卷 / 01期
关键词：
antineoplastic agents; body composition; head and neck neoplasms; radiotherapy; treatment outcome; LOCALLY ADVANCED HEAD; ANTICANCER DRUGS; SARCOPENIA; PREVALENCE; STRATEGIES; INTENSITY; OBESITY; IMPACT;
D O I：
10.1002/hed.26919
中图分类号：
R76 [耳鼻咽喉科学];
学科分类号：
100213 ;
摘要：
Background Low skeletal muscle mass (SMM) is an adverse prognostic factor for chemotherapy dose-limiting toxicity (CDLT). In patients with locally advanced head and neck squamous cell carcinoma (HNSCC) undergoing chemoradiotherapy (CRT), low SMM is a predictor for CDLT. We aimed to validate these findings. Methods Consecutive LA-HNSCC patients treated with primary CRT with high-dose cisplatin were retrospectively included. SMM was measured on pre-treatment CT-imaging. A cumulative cisplatin dose below 200 mg/m(2) was defined as CDLT. Results One hundred and fifty three patients were included; 37 (24.2%) experienced CDLT, and 84 had low SMM (54.9%). Patients with low SMM experienced more CDLT than patients with normal SMM (35.7% vs. 10.1%, p < 0.01). Low SMM (OR 3.99 [95% CI 1.56-10.23], p = 0.01) and an eGFR of 60-70 ml/min (OR 5.40 [95% CI 1.57-18.65], p < 0.01) were predictors for CDLT. Conclusion Pre-treatment low SMM is associated with CDLT in LA-HNSCC patients treated with primary CRT. Routine SMM assessment may allow for CDLT risk assessment and treatment optimization.
引用
收藏
页码：189 / 200
页数：12
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