Muscle depletion and the prediction of chemotherapy toxicity

Muscaritoli, Maurizio; Fanelli, Filippo Rossi

doi:10.1007/s11739-013-0966-2

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Several studies showed that the decrease of LBM is associated with higher chemotherapy toxicities, as well as a worse outcome in various cancer type [ 5 , 15 – 40 ]. Moreover, a muscle wasting without adipose tissue and body weight reduction was observed during anticancer treatment with both chemotherapy and target therapy [ 25 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, our results support literature data showing a relation between sarcopenia and toxicity in cancer patients. In fact, sarcopenia is associated to worse outcome, to higher risk of complication after surgical intervention, to higher mortality and to the risk of developing severe toxicities [ 5 , 13 ]. In particular, adverse events are the major cause of dose reduction, delaying of administration and therapy discontinuation.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, an inadequate response to anabolic stimuli or the upregulation of proteolysis in cancer are the principle causes of muscles loss [ 4 ]. In several studies, it has been showed that a lower LBM is associated with decreased survival, quality of life and tolerance to treatment [ 5 ]. The study of both fat and LBM at the level of the third lumbar vertebra (L3), performed by dual-energy X-ray absorptiometry (DXA) and/or computed tomography (CT) scan, appears to be strongly predictive of the entire body composition [ 6 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Lean body mass wasting and toxicity in early breast cancer patients receiving anthracyclines

et al. 2018

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BackgroundSarcopenia refers to the reduction of both volume and number of skeletal muscle fibers. Lean body mass loss is associated with survival, quality of life and tolerance to treatment in cancer patients. The aim of our study is to analyse the association between toxicities and sarcopenia in early breast cancer patients receiving adjuvant treatment.Materials and MethodsBreast cancer patients who have received anthracycline-based adjuvant treatment were retrospectively enrolled. CT scan images performed before, during and after adjuvant chemotherapy were used to evaluate lean body mass at third lumbar vertebra level with the software Slice Omatic V 5.0.Results21 stage I–III breast cancer patients were enrolled. According to the skeletal muscle index at third lumbar vertebra cut-off ≤38.5 cm2/m2, 8 patients (38.1%) were classified as sarcopenic before starting treatment, while 10 patients (47.6%) were sarcopenic at the end of treatment. A lower baseline L3 skeletal muscle index is associated with G3-4 vs G0-2 toxicities (33.4 cm2/m2 (31.1–39.9) vs 40.5 cm2/m2 (33.4–52.0), p = 0.028). Similarly skeletal muscle cross sectional area was significantly lower in patients with G3-4 toxicities (86.7 cm2 (82.6–104.7) vs 109.0 cm2 (83.3–143.9), p = 0.017). L3 skeletal muscle index is an independent predictor of severe toxicity (p = 0.0282) in multivariate analysis.ConclusionLean body mass loss is associated with higher grade of toxicity in early breast cancer patients receiving adjuvant chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Lean body mass wasting and toxicity in early breast cancer patients receiving anthracyclines

et al. 2018

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“…The allele of caveolin-1 G14713A may be used as an early marker for detection of sarcopenia [27]. resulting in increased toxicity due to higher concentrations and to a reduced drug clearance [28]. An alternative drug is recommended for poor chemotherapy metabolizers and a 50% decrease in starting dose for intermediate metabolizers [29].…”

Section: Diagnostic Criteria Of Sarcopeniamentioning

confidence: 99%

The Impact of Sarcopenia on Elderly Cancer Patients

Gioia¹

2017

Peertechz J Gerontol Geriatr Res

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Sarcopenia is a progressive loss of skeletal muscle mass and strength with consequent physical disability and negative impact on quality of life. Chemotherapy or surgery effi cacy on cancer is infl uenced by the presence of sarcopenia. In particular, chemotherapy toxicity is infl uenced by genetic variability because the expression of specifi c muscular enzymes, i.e. dihydropyrimidine dehydrogenase (DPD), play an important role in the catabolism of anti-cancer drugs. The reduction of the total body DPD activity in muscle tissue due to sarcopenia is related to severe chemotherapy-related side effects such as nausea, vomiting, diarrhea, neutropenia, anemia, and infections. Sarcopenia and its detrimental impact on patients' prognosis have been shown in several types of cancer, such as lung cancer, renal cancer, hepatocellular carcinoma, esophageal cancer, pancreatic cancer, breast cancer, medullary thyroid carcinoma, colorectal cancer, gastric cancer, urothelial cancer, hematologic malignancies etc. Sarcopenia may be optimally recognized by measures of muscle mass and physical performance and the diagnostic criteria. The presence of sarcopenia in elderly cancer patients should be routinely investigated by physicians in order to carry out appropriate nutritional and pharmacologic interventions.

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