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Changes in body composition and muscle attenuation during taxane-based chemotherapy in patients with metastatic breast cancer

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Abstract

Purpose

Body composition parameters including low muscle mass, muscle attenuation (which reflects muscle quality) and adipose tissue measurements have emerged as prognostic factors in cancer patients. However, knowledge regarding the possibility of excessive muscle loss during specific systemic therapies is unknown. We describe the changes in body composition and muscle attenuation (MA) during taxane- and anthracycline-based regimens and its association with overall survival (OS) in metastatic breast cancer patients.

Methods

The lumbar skeletal muscle index (LSMI) was used as marker of muscle mass. LSMI, MA, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and intramuscular adipose tissue (IMAT) were measured before and after first-line treatment with paclitaxel (n = 73) or 5-fluorouracil-doxorubicin-cyclophosphamide (FAC) (n = 25) using CT-images. Determinants of the change of LSMI and MA were analyzed using multiple linear regression. OS was assessed using Cox proportional hazard models.

Results

MA significantly decreased during paclitaxel treatment (− 0.9 HU, p = 0.03). LSMI (p = 0.40), SAT (p = 0.75), VAT (p = 0.84) and IMAT (p = 0.10) remained stable. No significant alterations in body composition parameters during FAC-treatment were observed. Previous (neo-)adjuvant chemotherapy contributed to larger loss of MA during the current treatment. Body composition changes during chemotherapy were not associated with OS.

Conclusions

MA decreased during treatment with paclitaxel, while muscle mass was stable. Body composition changes are not associated with survival in the absence of progressive disease.

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Acknowledgements

We thank Suze Roodenburg-Kooij for identifying the L3-level at all CT-images. We thank Daan Blinde for his participation in identifying patients eligible for inclusion using the radiology-registration in the Albert Schweitzer Hospital. We thank the ORAS foundation (Oncological Research Albert Schweitzer hospital) and the Leerhuis of the Albert Schweitzer hospital, Dordrecht, the Netherlands for the foundation of this study.

Funding

Funded by the ORAS foundation (Oncological Research Albert Schweitzer hospital) and the Leerhuis of the Albert Schweitzer hospital, Dordrecht, the Netherlands. The foundation had no involvement in the conduct of the study.

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Authors and Affiliations

  1. Department of Internal Medicine, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT, Dordrecht, The Netherlands

    Hánah N. Rier & Mark-David Levin

  2. Department of Medical Oncology, Erasmus MC Cancer Institute, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Hánah N. Rier, Agnes Jager & Stefan Sleijfer

  3. Department of Biostatistics, Erasmus MC, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Joost van Rosmalen

  4. Department of Radiology, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, 3318 AT, Dordrecht, The Netherlands

    Marc C. J. M. Kock

Authors
  1. Hánah N. Rier
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  2. Agnes Jager
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Correspondence to Hánah N. Rier.

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10549_2017_4574_MOESM1_ESM.tif

Kaplan–Meier curve for overall survival between included and excluded patients. The excluded patients undergoing palliative chemotherapy but without abdominal CT-imaging before and/or after treatment were included in this analysis. Median OS for the included patients was 33 months and for the excluded patients 23 months (log-rank p = 0.012). Supplementary material 1 (TIFF 78 kb)

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Rier, H.N., Jager, A., Sleijfer, S. et al. Changes in body composition and muscle attenuation during taxane-based chemotherapy in patients with metastatic breast cancer. Breast Cancer Res Treat 168, 95–105 (2018). https://doi.org/10.1007/s10549-017-4574-0

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  • DOI: https://doi.org/10.1007/s10549-017-4574-0

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