Format

Send to

Choose Destination
Support Care Cancer. 2018 Nov 26. doi: 10.1007/s00520-018-4563-9. [Epub ahead of print]

Early Skeletal Muscle Loss in Non-Small Cell Lung Cancer Patients Receiving Chemoradiation and Relationship to Survival.

Kiss N1,2,3, Beraldo J4, Everitt S4,5,6.

Author information

1
Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia. nicole.kiss@deakin.edu.au.
2
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. nicole.kiss@deakin.edu.au.
3
Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia. nicole.kiss@deakin.edu.au.
4
Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Victoria, 3002, Australia.
5
Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
6
Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Victoria, Australia.

Abstract

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.

KEYWORDS:

Body composition; Muscle loss; Non-small cell lung cancer; Nutrition; Sarcopenia

PMID:
30478673
DOI:
10.1007/s00520-018-4563-9

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center