Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty
This study was performed to identify treatment related toxicities in older adults undergoing concurrent chemoradiotherapy for head and neck cancer and nutritional and skeletal muscle measures that might identify frailty. Imaging analysis was done with the following skeletal muscle measurements: skel...
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MDPI AG
2022-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/9/2094 |
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| author | Ryan T. Morse Rohit G. Ganju Gregory N. Gan Ying Cao Prakash Neupane Kiran Kakarala Yelizaveta Shnayder Christopher E. Lominska |
| author_facet | Ryan T. Morse Rohit G. Ganju Gregory N. Gan Ying Cao Prakash Neupane Kiran Kakarala Yelizaveta Shnayder Christopher E. Lominska |
| author_sort | Ryan T. Morse |
| collection | DOAJ |
| description | This study was performed to identify treatment related toxicities in older adults undergoing concurrent chemoradiotherapy for head and neck cancer and nutritional and skeletal muscle measures that might identify frailty. Imaging analysis was done with the following skeletal muscle measurements: skeletal muscle index (SMI), skeletal muscle density (SMD), and skeletal muscle gauge (SMG). Patients were dichotomized by age into younger (<70 years old, 221 patients) and older age groups (≥70 years old, 51 patients). Low SMI was more common in older patients (86.7%) compared to younger patients (51.7%, <i>p</i> < 0.01), as were low SMD (57.8% vs. 37.3%, <i>p</i> = 0.012) and low SMG (76.1% vs. 44.2%, <i>p</i> < 0.01), despite having similar BMIs (27.3 kg/m<sup>2</sup> versus 27.7 kg/m<sup>2</sup>, <i>p</i> = 0.71). Older patients were significantly more likely to experience chemotherapy toxicity than younger patients (54.9% versus 32.3%, <i>p</i> < 0.01). On multivariate analysis age (<i>p</i> < 0.01), current smoking status (<i>p</i> < 0.01), and low SMI (<i>p</i> < 0.01) remained as significant predictors for missed chemotherapy cycles or discontinuation. Older patients were more likely to require ≥5-day radiation breaks than younger patients (27.5% versus 8.6%, <i>p</i> < 0.01). On multivariate analysis, age (<i>p</i> < 0.01), low albumin status (<i>p</i> = 0.03), and low SMI (<i>p</i> = 0.04) were identified as predictors of prolonged radiation treatment breaks. Based on the results of our study, sarcopenia may be used as an additional marker for frailty alongside traditional performance status scales. |
| first_indexed | 2024-03-10T04:19:26Z |
| format | Article |
| id | doaj.art-ea917d74c12e464a9db480c2b55b08c5 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T04:19:26Z |
| publishDate | 2022-04-01 |
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| series | Cancers |
| spelling | doaj.art-ea917d74c12e464a9db480c2b55b08c52023-11-23T07:54:45ZengMDPI AGCancers2072-66942022-04-01149209410.3390/cancers14092094Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict FrailtyRyan T. Morse0Rohit G. Ganju1Gregory N. Gan2Ying Cao3Prakash Neupane4Kiran Kakarala5Yelizaveta Shnayder6Christopher E. Lominska7Department of Radiation Oncology, UNC Lineberger Comprehensive Cancer Center, University of North Carolina Hospital, Chapel Hill, NC 27514, USADepartment of Radiation Oncology, Wellstar Health System, Marietta, GA 30067, USADepartment of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS 66160, USADepartment of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS 66160, USADepartment of Medical Oncology, University of Kansas Cancer Center, Kansas City, KS 66160, USADepartment of Otolaryngology, University of Kansas Cancer Center, Kansas City, KS 66160, USADepartment of Otolaryngology, University of Kansas Cancer Center, Kansas City, KS 66160, USADepartment of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS 66160, USAThis study was performed to identify treatment related toxicities in older adults undergoing concurrent chemoradiotherapy for head and neck cancer and nutritional and skeletal muscle measures that might identify frailty. Imaging analysis was done with the following skeletal muscle measurements: skeletal muscle index (SMI), skeletal muscle density (SMD), and skeletal muscle gauge (SMG). Patients were dichotomized by age into younger (<70 years old, 221 patients) and older age groups (≥70 years old, 51 patients). Low SMI was more common in older patients (86.7%) compared to younger patients (51.7%, <i>p</i> < 0.01), as were low SMD (57.8% vs. 37.3%, <i>p</i> = 0.012) and low SMG (76.1% vs. 44.2%, <i>p</i> < 0.01), despite having similar BMIs (27.3 kg/m<sup>2</sup> versus 27.7 kg/m<sup>2</sup>, <i>p</i> = 0.71). Older patients were significantly more likely to experience chemotherapy toxicity than younger patients (54.9% versus 32.3%, <i>p</i> < 0.01). On multivariate analysis age (<i>p</i> < 0.01), current smoking status (<i>p</i> < 0.01), and low SMI (<i>p</i> < 0.01) remained as significant predictors for missed chemotherapy cycles or discontinuation. Older patients were more likely to require ≥5-day radiation breaks than younger patients (27.5% versus 8.6%, <i>p</i> < 0.01). On multivariate analysis, age (<i>p</i> < 0.01), low albumin status (<i>p</i> = 0.03), and low SMI (<i>p</i> = 0.04) were identified as predictors of prolonged radiation treatment breaks. Based on the results of our study, sarcopenia may be used as an additional marker for frailty alongside traditional performance status scales.https://www.mdpi.com/2072-6694/14/9/2094geriatric oncologygeriatric assessmentsarcopeniatreatment toxicitychemotherapy |
| spellingShingle | Ryan T. Morse Rohit G. Ganju Gregory N. Gan Ying Cao Prakash Neupane Kiran Kakarala Yelizaveta Shnayder Christopher E. Lominska Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty Cancers geriatric oncology geriatric assessment sarcopenia treatment toxicity chemotherapy |
| title | Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty |
| title_full | Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty |
| title_fullStr | Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty |
| title_full_unstemmed | Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty |
| title_short | Sarcopenia and Treatment Toxicity in Older Adults Undergoing Chemoradiation for Head and Neck Cancer: Identifying Factors to Predict Frailty |
| title_sort | sarcopenia and treatment toxicity in older adults undergoing chemoradiation for head and neck cancer identifying factors to predict frailty |
| topic | geriatric oncology geriatric assessment sarcopenia treatment toxicity chemotherapy |
| url | https://www.mdpi.com/2072-6694/14/9/2094 |
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