Is computed-tomography-based body composition a reliable predictor of chemotherapy-related toxicity in pancreatic cancer patients?

Cefalì, Marco; Scala, Isabel; Pavone, Giuliana; Helbling, Daniel; Hussung, Saskia; Fritsch, Ralph; Reiner, Cäcilia; Stocker, Soleen; Koeberle, Dieter; Kissling, Marc; Chianca, Vito; Del Grande, Filippo; De Dosso, Sara; Rizzo, Stefania

doi:10.3390/cancers15174398

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De Dosso_2023_MDPI_Cancers_Is Computed-Tomography-Based

Journal article

Is computed-tomography-based body composition a reliable predictor of chemotherapy-related toxicity in pancreatic cancer patients?

Cefalì, Marco ORCID Institute of Oncology Research (IOR), Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Scala, Isabel Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Pavone, Giuliana ORCID Institute of Oncology Research (IOR), Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Helbling, Daniel Onkozentrum Zürich, Switzerland
Hussung, Saskia Department of Medical Oncology and Hematology, University Hospital of Zurich, Switzerland
Fritsch, Ralph Department of Medical Oncology and Hematology, University Hospital of Zurich, Switzerland
Reiner, Cäcilia Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
Stocker, Soleen Institute for Diagnostic and Interventional Radiology, University Hospital of Zurich, Switzerland
Koeberle, Dieter Oncology Departement, St. Claraspital, Basel, Switzerland
Kissling, Marc Radiology Department, St. Claraspital, Basel, Switzerland
Chianca, Vito Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
Del Grande, Filippo ORCID Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
De Dosso, Sara ORCID Institute of Oncology Research (IOR), Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
Rizzo, Stefania ORCID Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland

2023

Published in:

Cancers . - 2023, vol. 15, no. 17, p. 4398

English Background: Malnutrition, loss of weight and of skeletal muscle mass are frequent in pancreatic cancer patients, a majority of which will undergo chemotherapy over the course of their disease. Available data suggest a negative prognostic role of these changes in body composition on disease outcomes; however, it is unclear whether tolerance to chemotherapeutic treatment is similarly and/or negatively affected. We aimed to explore this association by retrospectively assessing changes in body composition and chemotherapy-related toxicity in a cohort of advanced pancreatic cancer patients. Methods: Body composition was evaluated through clinical parameters and through radiological assessment of muscle mass, skeletal muscle area, skeletal muscle index and skeletal muscle density; and an assessment of fat distribution by subcutaneous adipose tissue and visceral adipose tissue. We performed descriptive statistics, pre/post chemotherapy comparisons and uni- and multivariate analyses to assess the relation between changes in body composition and toxicity. Results: Toxicity risk increased with an increase of skeletal muscle index (OR: 1.03) and body mass index (OR: 1.07), whereas it decreased with an increase in skeletal muscle density (OR: 0.96). Multivariate analyses confirmed a reduction in the risk of toxicity only with an increase in skeletal muscle density (OR: 0.96). Conclusions: This study suggests that the retrospective analysis of changes in body composition is unlikely to be useful to predict toxicity to gemcitabine—nab-paclitaxel.

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