Impact of sarcopenia on survival and late toxicity in head and neck cancer patients treated with radiotherapy

被引：100
作者：
Van Rijn-Dekker, Maria, I [1 ]
van den Bosch, Lisa [1 ]
van den Hoek, Johanna G. M. [1 ]
Bijl, Hendrik P. [1 ]
van Aken, Evert S. M. [1 ]
van der Hoorn, Anouk [2 ]
Oosting, Sjoukje F. [3 ]
Halmos, Gyorgy B. [4 ]
Witjes, Max J. H. [5 ]
van der Laan, Hans P. [1 ]
Langendijk, Johannes A. [1 ]
Steenbakkers, Roel J. H. M. [1 ]
机构：
[1] Univ Groningen, Univ Med Ctr Groningen, Dept Radiat Oncol, POB 30001, NL-9700 RB Groningen, Netherlands
[2] Univ Groningen, Univ Med Ctr Groningen, Dept Radiol, Groningen, Netherlands
[3] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands
[4] Univ Groningen, Univ Med Ctr Groningen, Dept Otorhinolaryngol Head & Neck Surg, Groningen, Netherlands
[5] Univ Groningen, Univ Med Ctr Groningen, Dept Oral & Maxillofacial Surg, Groningen, Netherlands
来源：
RADIOTHERAPY AND ONCOLOGY | 2020年 / 147卷
关键词：
Head and neck cancer; Radiotherapy; Sarcopenia; Survival; Toxicities; SKELETAL-MUSCLE MASS; LOCALLY ADVANCED HEAD; HUMAN-PAPILLOMAVIRUS; COMPUTED-TOMOGRAPHY; RADIATION-THERAPY; BODY-COMPOSITION; SOLID TUMORS; XEROSTOMIA; PREDICTION; OUTCOMES;
D O I：
10.1016/j.radonc.2020.03.014
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Background and purpose: Sarcopenia is emerging as an adverse prognostic factor for survival and complication risk in cancer patients. This study aims to determine the impact of sarcopenia on survival and late toxicity in a large cohort of head and neck squamous cell carcinoma (HNSCC) patients treated with definitive (chemo)radiotherapy ((C)RT). Materials and methods: HNSCC patients treated with definitive (C)RT from January 2007 to June 2016 were included. Sarcopenia was assessed from radiation planning computed tomography (CT) scans using skeletal muscles at level C3. The impact of sarcopenia on overall survival (OS) and disease-free survival (DFS) was evaluated using the Kaplan-Meier method. Multivariable association models were developed to assess the impact of sarcopenia on late toxicity Results: The study population was composed of 750 HNSCC patients. Cut-off values for sarcopenia were set at SMI < 42.4 cm(2)/m(2) (men) and <30.6 cm(2)/m(2) (women) corresponding lowest gender specific quartile. Sarcopenic patients had significantly poorer survival rates, especially those with lower performance status and locally advanced disease. In oropharyngeal cancer patients, survival was more determined by p16 status than by sarcopenia. In multivariable analysis, sarcopenia was associated with worse OS (HR 0.72, p = 0.012) and DFS (HR 0.67, p = 0.001). In multivariable association models, sarcopenia was associated with physician-rated xerostomia six months after treatment (OR 1.65, p = 0.027) and physician-rated dysphagia six and twelve months after treatment (OR 2.02, p = 0.012 and 2.51, p = 0.003, respectively). Conclusion: Sarcopenia in HNSCC patients receiving definitive (C)RT is an independent prognostic factor for worse survival outcomes and is associated with physician-rated toxicity. (c) 2020 The Authors. Published by Elsevier B.V. Radiotherapy and Oncology 147 (2020) 103-110 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
引用
收藏
页码：103 / 110
页数：8
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