TY - JOUR
T1 - Impact of sarcopenia on acute radiation-induced toxicity in head and neck cancer patients
AU - Karavolia, Eleftheria
AU - van Rijn-Dekker, Irene
AU - van den Bosch, Lisa
AU - Hoek, Johanna Geertruida Maria van den
AU - Oldehinkel, Edwin
AU - van Zon-Meijer, Tineke
AU - Halmos, György B.
AU - Witjes, Max
AU - Oosting, S. F.
AU - van der Hoorn, Anouk
AU - Langendijk, J.A.
AU - Steenbakkers, Roel
N1 - Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2022/5
Y1 - 2022/5
N2 - 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 not improve the performance of these NTCP models (p > 0.99).Conclusion: Sarcopenia in HNC patients was an independent prognostic factor for radiation-induced physician-rated acute grade >= 3 dysphagia, which might be explained by its impact on swallowing muscles. However, addition of sarcopenia did not improve the NTCP model performance. (c) 2022 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 170 (2022) 122-128 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
AB - 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 not improve the performance of these NTCP models (p > 0.99).Conclusion: Sarcopenia in HNC patients was an independent prognostic factor for radiation-induced physician-rated acute grade >= 3 dysphagia, which might be explained by its impact on swallowing muscles. However, addition of sarcopenia did not improve the NTCP model performance. (c) 2022 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 170 (2022) 122-128 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
KW - Head and neck cancer
KW - Radiotherapy
KW - Sarcopenia
KW - Toxicities
KW - NTCP models
KW - QUALITY-OF-LIFE
KW - SKELETAL-MUSCLE MASS
KW - THERAPY
KW - ONCOLOGY
KW - EORTC
KW - RISK
U2 - 10.1016/j.radonc.2022.03.009
DO - 10.1016/j.radonc.2022.03.009
M3 - Article
C2 - 35304862
SN - 0167-8140
VL - 170
SP - 122
EP - 128
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -