Low muscle mass is associated with early termination of chemotherapy related to toxicity in patients with head and neck cancer

Martine J. Sealy, Tanadech Dechaphunkul, Cees P. van der Schans, Wim P Krijnen, Jan L. N. Roodenburg, John Walker, Harriët Jager-Wittenaar, Vickie E. Baracos

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND & AIMS: We studied whether low pre-treatment muscle mass, measured with CT at thoracic (T4) or lumbar level (L3) associates with early termination of chemotherapy related to toxicity in head and neck cancer (HNC) patients.

METHODS: This was a retrospective chart and image review. Adult HNC patients treated with (surgery and) platinum-based chemo-radiotherapy were included if a pre-treatment CT scan at T4 or L3 level was available. Muscle mass was evaluated by assessment of skeletal muscle index (SMI; cm2/m2). T4 and L3 SMI measurements were corrected for deviation from their respective means and were merged into one score for SMI difference (cm2/m2). All cases were assessed for presence of toxicity-related unplanned early termination of chemotherapy ('early termination'). Univariate and multivariate logistic regression models were used to investigate associations between pooled SMI and early termination.

RESULTS: 213 patients (age: 57.9 ± 10.3 y, male: 77%, T4 image: 45%) were included. A significant association between SMI as a continuous variable and early termination was found, both in the univariate analysis (p = 0.007, OR = 0.96 [0.94-0.99]) and the multivariate analysis (p = 0.021, OR 0.96 [0.92-0.99]). The multivariate models identified potential associations with type of chemotherapy, presence of co-morbidity, a combination of (former) smoking and alcohol consumption, and sex.

CONCLUSION: Lower muscle mass was robustly associated with higher odds of early termination of chemotherapy in HNC patients. Further prospective studies are required to tailor the care for patients with low muscle mass and to avoid early termination of chemotherapy.

Original languageEnglish
JournalClinical nutrition
Early online date22 Feb 2019
DOIs
Publication statusPublished - 2019

Keywords

  • muscle mass
  • chemo therapy

Cite this

@article{ecb22515e6e24358a8567d4b849fc3e3,
title = "Low muscle mass is associated with early termination of chemotherapy related to toxicity in patients with head and neck cancer",
abstract = "BACKGROUND & AIMS: We studied whether low pre-treatment muscle mass, measured with CT at thoracic (T4) or lumbar level (L3) associates with early termination of chemotherapy related to toxicity in head and neck cancer (HNC) patients.METHODS: This was a retrospective chart and image review. Adult HNC patients treated with (surgery and) platinum-based chemo-radiotherapy were included if a pre-treatment CT scan at T4 or L3 level was available. Muscle mass was evaluated by assessment of skeletal muscle index (SMI; cm2/m2). T4 and L3 SMI measurements were corrected for deviation from their respective means and were merged into one score for SMI difference (cm2/m2). All cases were assessed for presence of toxicity-related unplanned early termination of chemotherapy ('early termination'). Univariate and multivariate logistic regression models were used to investigate associations between pooled SMI and early termination.RESULTS: 213 patients (age: 57.9 ± 10.3 y, male: 77{\%}, T4 image: 45{\%}) were included. A significant association between SMI as a continuous variable and early termination was found, both in the univariate analysis (p = 0.007, OR = 0.96 [0.94-0.99]) and the multivariate analysis (p = 0.021, OR 0.96 [0.92-0.99]). The multivariate models identified potential associations with type of chemotherapy, presence of co-morbidity, a combination of (former) smoking and alcohol consumption, and sex.CONCLUSION: Lower muscle mass was robustly associated with higher odds of early termination of chemotherapy in HNC patients. Further prospective studies are required to tailor the care for patients with low muscle mass and to avoid early termination of chemotherapy.",
keywords = "muscle mass, chemo therapy, spiermassa, chemotherapie",
author = "Sealy, {Martine J.} and Tanadech Dechaphunkul and {van der Schans}, {Cees P.} and Krijnen, {Wim P} and Roodenburg, {Jan L. N.} and John Walker and Harri{\"e}t Jager-Wittenaar and Baracos, {Vickie E.}",
note = "Copyright {\circledC} 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.",
year = "2019",
doi = "10.1016/j.clnu.2019.02.029",
language = "English",
journal = "Clinical nutrition",
issn = "0261-5614",
publisher = "Churchill Livingstone",

}

Low muscle mass is associated with early termination of chemotherapy related to toxicity in patients with head and neck cancer. / Sealy, Martine J.; Dechaphunkul, Tanadech; van der Schans, Cees P.; Krijnen, Wim P; Roodenburg, Jan L. N.; Walker, John; Jager-Wittenaar, Harriët; Baracos, Vickie E.

In: Clinical nutrition, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Low muscle mass is associated with early termination of chemotherapy related to toxicity in patients with head and neck cancer

AU - Sealy, Martine J.

AU - Dechaphunkul, Tanadech

AU - van der Schans, Cees P.

AU - Krijnen, Wim P

AU - Roodenburg, Jan L. N.

AU - Walker, John

AU - Jager-Wittenaar, Harriët

AU - Baracos, Vickie E.

N1 - Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

PY - 2019

Y1 - 2019

N2 - BACKGROUND & AIMS: We studied whether low pre-treatment muscle mass, measured with CT at thoracic (T4) or lumbar level (L3) associates with early termination of chemotherapy related to toxicity in head and neck cancer (HNC) patients.METHODS: This was a retrospective chart and image review. Adult HNC patients treated with (surgery and) platinum-based chemo-radiotherapy were included if a pre-treatment CT scan at T4 or L3 level was available. Muscle mass was evaluated by assessment of skeletal muscle index (SMI; cm2/m2). T4 and L3 SMI measurements were corrected for deviation from their respective means and were merged into one score for SMI difference (cm2/m2). All cases were assessed for presence of toxicity-related unplanned early termination of chemotherapy ('early termination'). Univariate and multivariate logistic regression models were used to investigate associations between pooled SMI and early termination.RESULTS: 213 patients (age: 57.9 ± 10.3 y, male: 77%, T4 image: 45%) were included. A significant association between SMI as a continuous variable and early termination was found, both in the univariate analysis (p = 0.007, OR = 0.96 [0.94-0.99]) and the multivariate analysis (p = 0.021, OR 0.96 [0.92-0.99]). The multivariate models identified potential associations with type of chemotherapy, presence of co-morbidity, a combination of (former) smoking and alcohol consumption, and sex.CONCLUSION: Lower muscle mass was robustly associated with higher odds of early termination of chemotherapy in HNC patients. Further prospective studies are required to tailor the care for patients with low muscle mass and to avoid early termination of chemotherapy.

AB - BACKGROUND & AIMS: We studied whether low pre-treatment muscle mass, measured with CT at thoracic (T4) or lumbar level (L3) associates with early termination of chemotherapy related to toxicity in head and neck cancer (HNC) patients.METHODS: This was a retrospective chart and image review. Adult HNC patients treated with (surgery and) platinum-based chemo-radiotherapy were included if a pre-treatment CT scan at T4 or L3 level was available. Muscle mass was evaluated by assessment of skeletal muscle index (SMI; cm2/m2). T4 and L3 SMI measurements were corrected for deviation from their respective means and were merged into one score for SMI difference (cm2/m2). All cases were assessed for presence of toxicity-related unplanned early termination of chemotherapy ('early termination'). Univariate and multivariate logistic regression models were used to investigate associations between pooled SMI and early termination.RESULTS: 213 patients (age: 57.9 ± 10.3 y, male: 77%, T4 image: 45%) were included. A significant association between SMI as a continuous variable and early termination was found, both in the univariate analysis (p = 0.007, OR = 0.96 [0.94-0.99]) and the multivariate analysis (p = 0.021, OR 0.96 [0.92-0.99]). The multivariate models identified potential associations with type of chemotherapy, presence of co-morbidity, a combination of (former) smoking and alcohol consumption, and sex.CONCLUSION: Lower muscle mass was robustly associated with higher odds of early termination of chemotherapy in HNC patients. Further prospective studies are required to tailor the care for patients with low muscle mass and to avoid early termination of chemotherapy.

KW - muscle mass

KW - chemo therapy

KW - spiermassa

KW - chemotherapie

UR - http://www.mendeley.com/research/low-muscle-mass-associated-early-termination-chemotherapy-related-toxicity-patients-head-neck-cancer

U2 - 10.1016/j.clnu.2019.02.029

DO - 10.1016/j.clnu.2019.02.029

M3 - Article

JO - Clinical nutrition

JF - Clinical nutrition

SN - 0261-5614

ER -