Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia
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 ske...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/11/688 |
| _version_ | 1797459607942070272 |
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| author | Rushi Shah Clarissa Polen-De Michaela McGree Angela Fought Amanika Kumar |
| author_facet | Rushi Shah Clarissa Polen-De Michaela McGree Angela Fought Amanika Kumar |
| author_sort | Rushi Shah |
| collection | DOAJ |
| description | 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<sup>2</sup>/m<sup>2</sup> 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%, <i>p</i> = 0.02). The mean RDI for both carboplatin (80.4% vs. 89.4%, <i>p</i> = 0.03) and paclitaxel (91.9% vs. 104.1%, <i>p</i> = 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, <i>p</i> = 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. |
| first_indexed | 2024-03-09T16:54:46Z |
| format | Article |
| id | doaj.art-6eafa309341043ec8ffcdee1e9309214 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T16:54:46Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-6eafa309341043ec8ffcdee1e93092142023-11-24T14:37:03ZengMDPI AGCurrent Oncology1198-00521718-77292023-10-0130119501951310.3390/curroncol30110688Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of SarcopeniaRushi Shah0Clarissa Polen-De1Michaela McGree2Angela Fought3Amanika Kumar4Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USADepartment of Gynecologic Oncology, Summa Health, Akron, OH 44304, USADepartment of Quantitative Health Sciences, Division Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN 55905, USADepartment of Quantitative Health Sciences, Division Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN 55905, USADepartment of Obstetrics and Gynecology, Division of Gynecological Surgery, Mayo Clinic, Rochester, MN 55905, USAWe 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<sup>2</sup>/m<sup>2</sup> 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%, <i>p</i> = 0.02). The mean RDI for both carboplatin (80.4% vs. 89.4%, <i>p</i> = 0.03) and paclitaxel (91.9% vs. 104.1%, <i>p</i> = 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, <i>p</i> = 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.https://www.mdpi.com/1718-7729/30/11/688sarcopeniaadjuvant chemotherapyadvanced epithelial ovarian cancerrelative dose intensitycytoreductive surgeryoverall survival |
| spellingShingle | Rushi Shah Clarissa Polen-De Michaela McGree Angela Fought Amanika Kumar Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia Current Oncology sarcopenia adjuvant chemotherapy advanced epithelial ovarian cancer relative dose intensity cytoreductive surgery overall survival |
| title | Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia |
| title_full | Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia |
| title_fullStr | Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia |
| title_full_unstemmed | Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia |
| title_short | Re-Evaluating Chemotherapy Dosing Strategies for Ovarian Cancer: Impact of Sarcopenia |
| title_sort | re evaluating chemotherapy dosing strategies for ovarian cancer impact of sarcopenia |
| topic | sarcopenia adjuvant chemotherapy advanced epithelial ovarian cancer relative dose intensity cytoreductive surgery overall survival |
| url | https://www.mdpi.com/1718-7729/30/11/688 |
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