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Image-based analysis of skeletal muscle mass predicts cisplatin dose-limiting toxicity in patients with locally advanced head and neck cancer

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Abstract

Purpose

Evidence suggests that patients’ skeletal muscle mass (SMM) can predict the patients at risk for cisplatin dose-limiting toxicities (DLT). Cisplatin is currently dosed on body surface area (BSA). The predictive value of SMM for cisplatin DLT in patients with locally advanced head and neck cancer (LA-HNC) is investigated.

Methods

Patients with LA-HNC treated with cisplatin-based chemoradiotherapy (CRT) were included. SMM was measured using pre-treatment scans. Logistic regression analysis was performed to identify the predictive impact of low SMM for DLT.

Results

In total, 343 patients were included of which 199 patients (58.0%) had low SMM and 154 patients (44.9%) experienced cisplatin DLT. In multivariate analysis, low SMM at diagnosis was the only predictive factor for DLT (HR 1.8, 95% CI 1.1–2.9).

Conclusions

Low SMM was associated with an increased risk of DLT. Trials are needed to investigate cisplatin dosing with consideration of SMM rather than solely BSA.

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Abbreviations

LA-HNC:

Locally advanced head and neck cancer

SMA:

Skeletal muscle area

SMM:

Skeletal muscle mass

LSMI:

Lumbar skeletal muscle index

C3:

Third cervical vertebra

L3:

Third lumbar vertebra

HU:

Hounsfield unit

LBM:

Lean body mass

DLT:

Dose-limiting toxicity

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Funding

No financial support was received for this study.

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Authors and Affiliations

  1. Department of Head and Neck Surgical Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, House Postal Number Q.05.4.3003508 GA, Heidelberglaan 100, PO Box 85500, 3584 CX, Utrecht, The Netherlands

    Najiba Chargi, Fereshta Bashiri, Anne W. Wendrich & Remco de Bree

  2. Department of Radiation Oncology, Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Ernst J. Smid

  3. Department of Radiology, Division of Imaging and Oncology, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Pim A. de Jong

  4. Department of Clinical Pharmacy, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Alwin D. R. Huitema

  5. Department of Medical Oncology, Division of Imaging and Oncology, University Medical Center Utrecht and Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Lot. A. Devriese

  6. Department of Pharmacy and Pharmacology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Alwin D. R. Huitema

Authors
  1. Najiba Chargi
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  2. Fereshta Bashiri
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  3. Anne W. Wendrich
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  7. Lot. A. Devriese
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Correspondence to Remco de Bree.

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Chargi, N., Bashiri, F., Wendrich, A.W. et al. Image-based analysis of skeletal muscle mass predicts cisplatin dose-limiting toxicity in patients with locally advanced head and neck cancer. Eur Arch Otorhinolaryngol 279, 3685–3694 (2022). https://doi.org/10.1007/s00405-021-07229-y

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  • DOI: https://doi.org/10.1007/s00405-021-07229-y

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