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Early skeletal muscle loss in non-small cell lung cancer patients receiving chemoradiation and relationship to survival

journal contribution
posted on 2019-07-01, 00:00 authored by Nicole KissNicole Kiss, Julian Beraldo, Sarah Everitt
PURPOSE: Sarcopenia is associated with reduced survival in cancer. Currently, data on sarcopenia at presentation and muscle loss throughout treatment are unknown in patients receiving chemoradiation therapy (CRT) for non-small cell lung cancer (NSCLC). This study evaluated skeletal muscle changes in NSCLC patients receiving CRT and relationship with survival. METHODS: Secondary analysis of 41 patients with NSCLC treated with CRT assessed for skeletal muscle area and muscle density by computed tomography pre-treatment and 3 months post-treatment. Images at week 4 of treatment were available for 32 (78%) patients. Linear mixed models were applied to determine changes in skeletal muscle over time and related to overall survival using Kaplan-Meier plots. RESULTS: Muscle area and muscle density decreased significantly by week 4 of CRT (- 6.6 cm2, 95% CI - 9.7 to - 3.1, p < 0.001; - 1.3 HU, 95% CI - 1.9 to - 0.64, p < 0.001, respectively), with minimal change between week 4 of CRT and 3 months post-CRT follow-up (- 0.2 cm2, 95% CI - 3.6-3.1, p = 0.91; - 0.27, 95% CI - 0.91-0.36, p = 0.36, respectively). Sarcopenia was present in 25 (61%) and sarcopenic obesity in 6 (14%) of patients prior to CRT, but not associated with poorer survival. Median survival was shorter in patients with low muscle density prior to treatment although not statistically significant (25 months + 8.3 vs 53 months + 13.0, log-rank p = 0.17). CONCLUSION: Significant loss of muscle area and muscle density occurs in NSCLC patients early during CRT. A high proportion of patients are sarcopenic prior to CRT; however, this was not significantly associated with poorer survival.

History

Journal

Support care in cancer

Volume

27

Issue

7

Pagination

2657 - 2664

Publisher

Springer

Location

Cham, Switzerland

eISSN

1433-7339

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2018, Springer-Verlag GmbH Germany