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.

Abstract

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/m2 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.

• Authors: Sandra I Bril, Abrahim Al-Mamgani, Najiba Chargi, Peter Remeijer, Lot A Devriese, Jan Paul de Boer, Remco de Bree
• Journal: Head & neck (Head Neck) Vol. 44 Issue 1 Pg. 189-200 (01 2022) ISSN: 1097-0347 [Electronic] United States
• PMID: 34713519 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 The Authors. Head & Neck published by Wiley Periodicals LLC.

Chemical References

• Cisplatin

Topics

• Antineoplastic Combined Chemotherapy Protocols
• Chemoradiotherapy (adverse effects)
• Cisplatin (adverse effects)
• Head and Neck Neoplasms (therapy)
• Humans
• Muscle, Skeletal
• Retrospective Studies