The association of body composition parameters and adverse events in women receiving chemotherapy for early breast cancer

被引:16
作者
Aleixo, G. F. P. [1 ,2 ]
Shachar, S. S. [3 ]
Deal, A. M. [4 ]
Nyrop, K. A. [1 ,4 ]
Muss, H. B. [1 ,4 ]
Chen, Y. T. [4 ]
Yu, H. [5 ]
Williams, G. R. [6 ]
机构
[1] Univ North Carolina Chapel Hill, Div Hematol Oncol, 170 Manning Dr, Chapel Hill, NC 27599 USA
[2] Univ Oeste Paulista UNOESTE, Presidente Prudente, SP, Brazil
[3] Technion, Ruth & Bruce Rappaport Fac Med, Haifa, Israel
[4] Univ North Carolina Chapel Hill, Lineberger Comprehens Canc Ctr, Chapel Hill, NC USA
[5] Univ North Carolina Chapel Hill, Div Radiol, Chapel Hill, NC USA
[6] Univ Alabama Birmingham, Div Hematol Oncol, Birmingham, AL USA
关键词
Breast cancer; Myosteatosis; Chemotherapy outcomes; SKELETAL-MUSCLE; PROGNOSTIC-FACTOR; OBESE-PATIENTS; OLDER-ADULTS; SARCOPENIA; SURVIVAL; TOXICITY; TRENDS; IMPACT; TIME;
D O I
10.1007/s10549-020-05731-1
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Body composition metrics as predictors of adverse events are a growing area of interest in oncology research. One barrier to the use of these metrics in clinical practice is the lack of standardized cut points for identifying patients with at-risk body composition profiles. We examined the association of chemotherapy adverse events with several body composition measures, using alternative cut points from published studies. Methods This is a retrospective study of women diagnosed with early breast cancer (EBC). Axial computerized tomography (CT) images from lumbar L3 segments were analyzed for the following body composition measures: myosteatosis (low Skeletal Muscle Density/SMD), sarcopenia (low Skeletal Muscle Index/SMI), and high Visceral Adipose Tissue (VAT). Adverse events during chemotherapy were dose reduction, early treatment discontinuation, and hospitalization. Log-binomial modeling was used to evaluate associations between body composition measures at different cut points with adverse events, adjusting for age, race, Body Mass Index/BMI, and comorbidities. Relative risks were reported as the measure of association. Results In a sample of 338 women, mean age was 51, 14% were age 65 or older, 32% were non-white, 40% had obesity (/BMI >= 30 kg/m(2)), and mean number of comorbidities was 1.56. In multivariable analysis (MV), all three SMD cut points for myosteatosis had significant associations with total number of adverse events, as well as different cut points having significant associations with either dose reduction, early treatment discontinuation or hospitalization. SMI and VAT were not significant in the MV analysis; however, in some models, age and total comorbidities were significant for adverse events. Conclusions Among CT-derived measures of body composition, myosteatosis determined at any of three SMD cut points was associated with total and individual adverse events during chemotherapy for early breast cancer.
引用
收藏
页码:631 / 642
页数:12
相关论文
共 36 条
[1]   Outcomes of early-stage breast cancer patients treated with sequential anthracyclines-taxanes in relationship to relative dosing intensity: a secondary analysis of a randomized controlled trial [J].
Abdel-Rahman, O. .
CLINICAL & TRANSLATIONAL ONCOLOGY, 2019, 21 (02) :239-245
[2]   Myosteatosis and prognosis in cancer: Systematic review and meta-analysis [J].
Aleixo, G. F. P. ;
Shachar, S. S. ;
Nyrop, K. A. ;
Muss, H. B. ;
Malpica, Luis ;
Williams, G. R. .
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2020, 145
[3]   Muscle composition and outcomes in patients with breast cancer: meta-analysis and systematic review [J].
Aleixo, G. F. P. ;
Williams, G. R. ;
Nyrop, K. A. ;
Muss, H. B. ;
Shachar, S. S. .
BREAST CANCER RESEARCH AND TREATMENT, 2019, 177 (03) :569-579
[4]   Relationship between computed tomography-derived body composition, sex, and post-operative complications in patients with colorectal cancer [J].
Almasaudi, Arwa S. ;
Dolan, Ross D. ;
McSorley, Stephen T. ;
Horgan, Paul G. ;
Edwards, Christine ;
McMillan, Donald C. .
EUROPEAN JOURNAL OF CLINICAL NUTRITION, 2019, 73 (11) :1450-1457
[5]   Chemotherapy-Induced Sarcopenia [J].
Bozzetti, Federico .
CURRENT TREATMENT OPTIONS IN ONCOLOGY, 2020, 21 (01)
[6]   The Importance of Body Composition in Explaining the Overweight Paradox in Cancer [J].
Caan, Bette J. ;
Feliciano, Elizabeth M. Cespedes ;
Kroenke, Candyce H. .
CANCER RESEARCH, 2018, 78 (08) :1906-1912
[7]  
Caan BJ, 2018, JAMA ONCOL, V4, P798, DOI 10.1001/jamaoncol.2018.0137
[8]   Body Composition, Adherence to Anthracycline and Taxane-Based Chemotherapy, and Survival After Nonmetastatic Breast Cancer [J].
Cespedes Feliciano, Elizabeth M. ;
Chen, Wendy Y. ;
Lee, Valerie ;
Albers, Kathleen B. ;
Prado, Carla M. ;
Alexeeff, Stacey ;
Xiao, Jingjie ;
Shachar, Shlomit S. ;
Caan, Bette J. .
JAMA ONCOLOGY, 2020, 6 (02) :264-270
[9]   Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors [J].
Cespedes Feliciano, Elizabeth M. ;
Chen, Wendy Y. ;
Bradshaw, Patrick T. ;
Prado, Carla M. ;
Alexeeff, Stacey ;
Albers, Kathleen B. ;
Castillo, Adrienne L. ;
Caan, Bette J. .
JOURNAL OF CLINICAL ONCOLOGY, 2019, 37 (28) :2528-+
[10]   Impact of body composition on outcome in patients with early breast cancer [J].
Deluche, Elise ;
Leobon, Sophie ;
Desport, Jean Claude ;
Venat-Bouvet, Laurence ;
Usseglio, Julie ;
Tubiana-Mathieu, Nicole .
SUPPORTIVE CARE IN CANCER, 2018, 26 (03) :861-868