Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia.
Rushi ShahClarissa Polen-DeMichaela McGreeAngela FoughtAmanika KumarPublished in: Current oncology (Toronto, Ont.) (2023)
We investigated the impact of sarcopenia on adjuvant chemotherapy dosing in advanced epithelial ovarian cancer (EOC). The chemotherapy dosing and toxicity of 173 eligible patients who underwent cytoreductive surgery and adjuvant chemotherapy at a single institution were analyzed. Patients with a skeletal muscle index less than 39 cm 2 /m 2 measured on a CT scan were considered sarcopenic. Sarcopenic and non-sarcopenic patients were compared with regard to relative dose intensity (RDI), completion of scheduled chemotherapy, toxicity, and survival. A total of 62 (35.8%) women were sarcopenic. Sarcopenic women were less likely to complete at least six cycles of chemotherapy (83.9% vs. 95.5%, p = 0.02). The mean RDI for both carboplatin (80.4% vs. 89.4%, p = 0.03) and paclitaxel (91.9% vs. 104.1%, p = 0.03) was lower in sarcopenic patients compared to non-sarcopenic patients. Despite these differences in chemotherapy, there was no difference in neutropenia or median overall survival (3.99 vs. 4.57 years, p = 0.62) between the sarcopenic and non-sarcopenic women, respectively. This study highlights the importance of considering lean body mass instead of body weight or surface area in chemotherapy dosing formulas for sarcopenic women with advanced EOC. Further research is needed to optimize chemotherapy strategies based on individual body composition, potentially leading to improved dosing strategies in this population.
Keyphrases
- end stage renal disease
- body composition
- skeletal muscle
- ejection fraction
- newly diagnosed
- chronic kidney disease
- locally advanced
- prognostic factors
- peritoneal dialysis
- type diabetes
- body weight
- randomized controlled trial
- magnetic resonance imaging
- computed tomography
- polycystic ovary syndrome
- coronary artery disease
- acute coronary syndrome
- atrial fibrillation
- magnetic resonance
- positron emission tomography
- mass spectrometry
- bone mineral density
- open label
- pet ct
- percutaneous coronary intervention
- surgical site infection