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. 2022 Sep 29:12:974116.
doi: 10.3389/fonc.2022.974116. eCollection 2022.

Body composition as a predictor of chemotherapy-related toxicity in pancreatic cancer patients: A systematic review

Stefania Rizzo  1   2 , Isabel Scala  2 , Angela Rodriguez Robayo  3 , Marco Cefalì  4 , Sara De Dosso  2   4 , Stefano Cappio  1 , Genti Xhepa  1 , Filippo Del Grande  1   2
Affiliations

Body composition as a predictor of chemotherapy-related toxicity in pancreatic cancer patients: A systematic review

Stefania Rizzo et al. Front Oncol. .

Abstract

Objectives: The objective of this systematic review was to assess associations between quantitative body composition measures extracted from imaging examinations and chemotherapy-related toxicity in pancreatic cancer patients. A secondary objective was to evaluate the different definitions of sarcopenia across included studies.

Methods: This systematic review was conducted according to the PRISMA statement. A comprehensive literature search of three electronic databases was performed by two authors. For each eligible article, information was collected concerning the clinical setting; basic study; population characteristics; technical; body composition features evaluated; CA 19.9 tumor marker levels; chemotherapy drugs administered; toxicities (hematologic, nausea/vomiting, diarrhea, neuropathy, reduction of number of cycles, overall toxicity); association of body composition values with toxicities. The overall quality of the included studies was critically evaluated.

Results: After the initial retrieval of 1137 articles, the systematic review included 12 articles (1/12 in the neo-adjuvant setting; 2/12 in the adjuvant setting; 3/12 in the metastatic setting; 2/12 in the unresectable setting; the other 4/12 included more than one clinical setting). The number of patients included ranged between 17 and 251; mean/median age ranged between 63 and 77 years; the percentage of sarcopenic patients ranged between 23 and 76%. The most frequent body composition parameter evaluated was skeletal muscle index (11/12). Chemotherapy regimens included gemcitabine (as monotherapy or in combination with other drugs); FOLFIRINOX and S-1. Among the trials including gemcitabine, 2/9 demonstrated an association with toxicity, whereas 7/9 did not; among those including FOLFIRINOX, one demonstrated associated toxicity whereas the others did not. Altogether, 4/12 papers demonstrated an association between the body composition values and the development of chemotherapy-related toxicities.

Conclusions: There is a wide variability of results about the association of body composition and chemotherapy-related toxicity in PC patients. Furthermore, cut-off values to define sarcopenia in PC patients are not yet uniformly defined.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022337753, identifier CRD42022337753.

Keywords: body composition; chemotherapy; pancreatic cancer; sarcopenia; toxicity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study selection flowchart.
Figure 2
Figure 2
Overall Quality Assessment of the Studies Included in the Systematic Review, according to the QUADAS–2 Tool.
See this image and copyright information in PMC

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