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. 2022 Jul;279(7):3685-3694.
doi: 10.1007/s00405-021-07229-y. Epub 2022 Jan 17.

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

Najiba Chargi  1 , Fereshta Bashiri  1 , Anne W Wendrich  1 , Ernst J Smid  2 , Pim A de Jong  3 , Alwin D R Huitema  4   5 , Lot A Devriese  6 , Remco de Bree  7
Affiliations

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

Najiba Chargi et al. Eur Arch Otorhinolaryngol. 2022 Jul.

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.

Keywords: Body composition; Chemoradiotherapy; Head and neck cancer; Image-based analysis; Sarcopenia; Skeletal muscle mass.

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