Low Skeletal Muscle Mass Impairs Quality of Life in Nasopharyngeal Carcinoma Patients Treated With Concurrent Chemoradiotherapy

Hua, Xin; Liao, Jyh‐Fei; Liu, Shan; Zhang, Jun; Huang, Han-Ying; Wen, Wen; Long, Zhi‐Qing; Zhang, Wen; Guo, Ling; Lin, Huan‐Xin

doi:10.3389/fnut.2019.00195

Cited by 6 publications

(39 citation statements)

References 37 publications

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“…The method described in Hua et al. ( 19 ) was used to measure skeletal muscle area at the third cervical vertebrae level. Routine clinicopathological data were collected within 1 week of treatment, and the monocyte count divided by the lymphocyte count was used as the MLR.…”

Section: Methodsmentioning

confidence: 99%

“…The SMI was used to evaluate the presence of sarcopenia, and was calculated as the patient's skeletal muscle area (cm 2 ) divided by their height squared (m 2 ). The method described in Hua et al (19) was used to measure skeletal muscle area at the third cervical vertebrae level. Routine clinicopathological data were collected within 1 week of treatment, and the monocyte count divided by the lymphocyte count was used as the MLR.…”

Section: Data Collection and Definitionsmentioning

confidence: 99%

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A Model Combining Skeletal Muscle Mass and a Hematological Biomarker to Predict Survival in Patients With Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy

et al. 2021

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BackgroundUsing the current tumor lymph node metastasis (TNM) staging system to make treatment decisions and predict survival in patients with nasopharyngeal carcinoma (NPC) lacks sufficient accuracy. Patients at the same stage often have different survival prognoses.MethodsIn the current study 802 NPC patients who underwent concurrent radiotherapy and chemotherapy from January 2010 to December 2014 at Sun Yat-sen University Cancer Center in China were retrospectively assessed. The optimal cut-off points for skeletal muscle index (SMI) and monocyte-to-lymphocyte ratio (MLR) were determined via receiver operating characteristic curves. SMI-MLR (S-M) grade and a nomogram were developed and used as clinical indicators in NPC patients. The consistency index (C-index) and a calibration curve were used to measure the accuracy and discriminative capacity of prediction.ResultsThe predictive performance of S-M grade was better than that of TNM staging (C-index 0.639, range 0.578–0.701 vs. 0.605, range 0.545–0.665; p = 0.037). In multivariate analysis S-M grade, T stage, and N stage were independent prognostic factors. These three factors were then combined, yielding a nomogram with a C-index of 0.71 (range 0.64–0.77), indicating good predictive capacity.ConclusionWe developed and validated a prognostic parameter, S-M grade, which increased prediction accuracy significantly and can be combined with TNM staging to predict survival in patients with NPC undergoing concurrent chemoradiotherapy.

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Section: Methodsmentioning

confidence: 99%

Section: Data Collection and Definitionsmentioning

confidence: 99%

A Model Combining Skeletal Muscle Mass and a Hematological Biomarker to Predict Survival in Patients With Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy

et al. 2021

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“…The number of patient scans used in each study varied, with the majority 24/32 (75 %) having sample sizes <250, with only three studies having much larger cohorts of >800 (51)(52)(53) . The majority (52 %) of papers focused on muscle mass assessment in patients with head and neck cancer (HNC) (seventeen studies (51,52,(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68) ), with ten (32 %) investigating lung cancer (69)(70)(71)(72)(73)(74)(75)(76)(77)(78) and the remaining papers focusing on a mixed tumour cohort of head and neck, lung, breast and colorectal (53,(79)(80)(81)(82) . More detailed characteristics of the studies are shown in Table 1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The Slice-O-Matic (Tomovision, Canada) medical imaging software was used in the majority of studies (15/32, 47 %), with the remainder using either in-house software or different (64) China þ…”

Section: Analysis Of Computed Tomography Scansmentioning

confidence: 99%

“…software packages. Fifteen papers used a cervical vertebral slice (C3) (54)(55)(56)(57)(59)(60)(61)(62)(63)(64)(65)(66)68,80) with most using the study by Swartz et al as the reference for the use of C3, and applying the prediction formula described to the CSA at C3 to predict CSA at L3 (56) . Seven of these studies were conducted at the same institution in the Netherlands where the use of C3 in muscle mass estimation was first investigated (54)(55)(56)(57)59,(66)(67)(68) .…”

Section: C3mentioning

confidence: 99%

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The use of alternate vertebral levels to L3 in computed tomography scans for skeletal muscle mass evaluation and sarcopenia assessment in patients with cancer: a systematic review

et al. 2021

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Body composition measurement using diagnostic computed tomography (CT) scans has emerged as a method to assess sarcopenia (low muscle mass) in oncology patients. Assessment of skeletal muscle mass (SMM) using the cross-sectional area (CSA) of a single vertebral slice (at lumbar L3) in a CT scan is correlated to whole body skeletal muscle volume. This method is used to assess CT-defined sarcopenia in patients with cancer, with low SMM effecting outcomes. However, as diagnostic scans are based on tumour location, not all include L3. We evaluated the evidence for the use of alternate vertebral CT slices for SMM evaluation when L3 is not available. Five electronic databases were searched from Jan 1996-April 2020 for studies using CT scan vertebral slices above L3 for SM measurement in adults with cancer (solid tumours). Validation with whole body SMM, rationale for the chosen slice, and sarcopenia cut-off values were investigated. Thirty-two studies were included, all retrospective and cross-sectional in design. Cervical, thoracic, and lumbar slices were used (from C3-L1), with no validation of whole body SMM using CT scans. Alternate slices were used in lung, and head and neck cancer patients. Sarcopenia cut-off values were reported in 75% of studies, with differing methods, with or without sex-specific values, and a lack of consensus. Current evidence is inadequate to provide definitive recommendations for alternate vertebral slice use for SMM evaluation in cancer patients. Variation in sarcopenia cut-offs warrants more robust investigation, in order for risk stratification to be applied to all patients with cancer.

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Association between skeletal muscle mass and quality of life in adults with cancer: a systematic review and meta‐analysis

Hanna

Nguo

Furness

et al. 2022

J cachexia sarcopenia muscle

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Low skeletal muscle mass is known to be associated with poor morbidity and mortality outcomes in cancer, but evidence of its impact on health‐related quality of life (HRQOL) is less established. This systematic review and meta‐analysis was performed to investigate the relationship between skeletal muscle mass and HRQOL in adults with cancer. Five databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus, Scopus, and PsycInfo) were systematically searched from 1 January 2007 until 2 September 2020. Studies reporting on the association between measures of skeletal muscle (mass and/or radiodensity) derived from analysis of computed tomography imaging, and a validated measure of HRQOL in adults with cancer, were considered for inclusion. Studies classifying skeletal muscle mass as a categorical variable (low or normal) were combined in a meta‐analysis to investigate cross‐sectional association with HRQOL. Studies reporting skeletal muscle as a continuous variable were qualitatively synthesized. A total of 14 studies involving 2776 participants were eligible for inclusion. Skeletal muscle mass classified as low or normal was used to dichotomize participants in 10 studies (n = 1375). Five different cut points were used for classification across the 10 studies, with low muscle mass attributed to 58% of participants. Low muscle mass was associated with poorer global HRQOL scores [n = 985 from seven studies, standardized mean difference −0.27, 95% confidence interval (CI) −0.40 to −0.14, P < 0.0001], and poorer physical functioning domain HRQOL scores (n = 507 from five studies, standardized mean difference −0.40, 95% CI −0.74 to −0.05, P = 0.02), but not social, role, emotional, or cognitive functioning domain scores (all P > 0.05). Five studies examined the cross‐sectional relationship between HRQOL and skeletal muscle mass as a continuous variable and found little evidence of an association unless non‐linear analysis was used. Two studies investigated the relationship between longitudinal changes in both skeletal muscle and HRQOL, reporting that an association exists across several HRQOL domains. Low muscle mass may be associated with lower global and physical functioning HRQOL scores in adults with cancer. The interpretation of this relationship is limited by the varied classification of low muscle mass between studies. There is a need for prospective, longitudinal studies examining the interplay between skeletal muscle mass and HRQOL over time, and data should be made accessible to enable reanalysis according to different cut points. Further research is needed to elucidate the causal pathways between these outcomes.

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Low Skeletal Muscle Mass Impairs Quality of Life in Nasopharyngeal Carcinoma Patients Treated With Concurrent Chemoradiotherapy

Cited by 6 publications

References 37 publications

A Model Combining Skeletal Muscle Mass and a Hematological Biomarker to Predict Survival in Patients With Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy

A Model Combining Skeletal Muscle Mass and a Hematological Biomarker to Predict Survival in Patients With Nasopharyngeal Carcinoma Undergoing Concurrent Chemoradiotherapy

The use of alternate vertebral levels to L3 in computed tomography scans for skeletal muscle mass evaluation and sarcopenia assessment in patients with cancer: a systematic review

Association between skeletal muscle mass and quality of life in adults with cancer: a systematic review and meta‐analysis

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