Impact of sarcopenia on acute radiation-induced toxicity in head and neck cancer patients

作者：Eleftheria Karavolia, Maria I. van Rijn–Dekker, L. Van den Bosch, Johanna G.M. van den Hoek, Edwin Oldehinkel, Tineke W.H. Meijer, György B. Halmos, Max J. H. Witjes, Sjoukje F. Oosting, Anouk van der Hoorn, Johannes A. Langendijk, R.J.H.M. Steenbakkers · 发表于：Radiotherapy and Oncology · 年份：2022 · DOI：10.1016/j.radonc.2022.03.009 · 被引用次数：35 · 研究领域：Nutrition and Health in Aging、Dysphagia Assessment and Management、Oral health in cancer treatment

BACKGROUND AND PURPOSE: Sarcopenia is related to late radiation-induced toxicities and worse survival in head and neck cancer (HNC) patients. This study tested the hypothesis that sarcopenia improves the performance of current normal tissue complication probability (NTCP) models of radiation-induced acute toxicity in HNC patients. MATERIAL/METHODS: This was a retrospective analysis in a prospective cohort of HNC patients treated from January 2007 to December 2018 with (chemo)radiotherapy. Planning CT scans were used for evaluating skeletal muscle mass. Characteristics of sarcopenic and non-sarcopenic patients were compared. The impact of sarcopenia was analysed by adding sarcopenia to the linear predictors of current NTCP models predicting physician- and patient-rated acute toxicities. RESULTS: The cut-off values of sarcopenia in the study population (n = 977) were established at skeletal muscle index < 42.0 cm2/m2 (men) and < 31.2 cm2/m2 (women), corresponding to the lowest sex-specific quartile. Compared to non-sarcopenic patients, sarcopenic patients were more frequently smokers (61% vs. 48%, p < 0.001), had more often advanced stage of disease (stage III-IV, p = 0.004), higher age (67 vs. 63 years, p < 0.001) and experienced more pretreatment complaints, such as dysphagia (grade ≥ 2, p < 0.001). Sarcopenia remained statistically significant, next to the linear predictor, only for physician-rated grade ≥ 3 dysphagia (week 3-6 during RT, p < 0.01). However, sarcopenia did n...