Sarcopenia is associated with chemoradiotherapy discontinuation and reduced progression-free survival in glioblastoma patients.

Autor: Troschel FM; Department of Radiation Oncology, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. fabian.troschel@uni-muenster.de., Troschel BO; Department of Radiation Oncology, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Kloss M; Department of Neurosurgery, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Jost J; Department of Neurosurgery, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Pepper NB; Department of Radiation Oncology, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Völk-Troschel AS; Department of Medicine II, Klinikum Wolfsburg, Sauerbruchstraße 7, 38440, Wolfsburg, Germany., Wiewrodt RG; Pulmonary Research Division, Münster University, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.; Department of Pulmonary Medicine, Mathias Foundation, Hospitals Rheine and Ibbenbüren, Frankenburgsstraße 31, 48431, Rheine, Germany., Stummer W; Department of Neurosurgery, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Wiewrodt D; Department of Neurosurgery, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany., Eich HT; Department of Radiation Oncology, Münster University Hospital, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
Jazyk: angličtina
Zdroj: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] [Strahlenther Onkol] 2024 Sep; Vol. 200 (9), pp. 774-784. Date of Electronic Publication: 2024 Mar 28.
DOI: 10.1007/s00066-024-02225-7
Abstrakt: Purpose: Sarcopenia may complicate treatment in cancer patients. Herein, we assessed whether sarcopenia measurements derived from radiation planning computed tomography (CT) were associated with complications and tumor progression during radiochemotherapy for glioblastoma.
Methods: Consecutive patients undergoing radiotherapy planning for glioblastoma between 2010 and 2021 were analyzed. Retrocervical muscle cross-sectional area (CSA) was measured via threshold-based semi-automated radiation planning CT analysis. Patients in the lowest sex-specific quartile of muscle measurements were defined as sarcopenic. We abstracted treatment characteristics and tumor progression from the medical records and performed uni- and multivariable time-to-event analyses.
Results: We included 363 patients in our cohort (41.6% female, median age 63 years, median time to progression 7.7 months). Sarcopenic patients were less likely to receive chemotherapy (p < 0.001) and more likely to be treated with hypofractionated radiotherapy (p = 0.005). Despite abbreviated treatment, they more often discontinued radiotherapy (p = 0.023) and were more frequently prescribed corticosteroids (p = 0.014). After treatment, they were more often transferred to inpatient palliative care treatment (p = 0.035). Finally, progression-free survival was substantially shorter in sarcopenic patients in univariable (median 5.1 vs. 8.4 months, p < 0.001) and multivariable modeling (hazard ratio 0.61 [confidence interval 0.46-0.81], p = 0.001).
Conclusion: Sarcopenia is a strong risk factor for treatment discontinuation and reduced progression-free survival in glioblastoma patients. We propose that sarcopenic patients should receive intensified supportive care during radiotherapy and during follow-up as well as expedited access to palliative care.
(© 2024. The Author(s).)
Databáze: MEDLINE
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