Prognostic Impact of Sarcopenia’s Occurrence during Radiotherapy in Oropharyngeal Cancer Patients

Author:

Bergamaschi Luca1,Marvaso Giulia12ORCID,Zaffaroni Mattia1ORCID,Vincini Maria Giulia1ORCID,D’Ecclesiis Oriana3,Volpe Stefania12,Ferrari Annamaria1,Zorzi Stefano Filippo4,Rocca Maria Cossu5ORCID,Sabbatini Annarita6,Cannillo Giulia6,Zagallo Emanuela6,Starzyńska Anna7ORCID,Ansarin Mohssen4,Cattani Federica8,Gandini Sara3ORCID,Orecchia Roberto89,Alterio Daniela1,Jereczek-Fossa Barbara Alicja12

Affiliation:

1. Division of Radiation Oncology, European Institute of Oncology IRCCS, 20141 Milan, Italy

2. Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy

3. Department of Experimental Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy

4. Department of Otolaryngology and Head and Neck Surgery, European Institute of Oncology IRCCS, 20141 Milan, Italy

5. Department of Medical Oncology, Urogenital and Head and Neck Tumors Medical Treatment, European Institute of Oncology IRCCS, 20141 Milan, Italy

6. Dietetic and Clinical Nutrition Unit, European Institute of Oncology IRCSS, 20141 Milan, Italy

7. Department of Oral Surgery, Medical University of Gdańsk, 80210 Gdańsk, Poland

8. Unit of Medical Physics, European Institute of Oncology, IRCCS, 20141 Milan, Italy

9. Scientific Directorate, European Institute of Oncology, IRCCS, 20141 Milan, Italy

Abstract

The current study aims to profile sarcopenic condition (both at baseline and developed during treatment) in oropharyngeal carcinoma (OPC) patients treated with curative radiotherapy (RT) +/− chemotherapy and to evaluate its impact on oncological outcomes and toxicity. A total of 116 patients were included in this retrospective single-center study. Sarcopenia assessment at baseline and at 50 Gy re-evaluation CT was obtained from two different methodologies: (i) the L3-skeletal muscle index (SMI) derived from the contouring of the cross-sectional area (CSA) of the masticatory muscles (CSA-MM); and (ii) the paravertebral and sternocleidomastoid muscles at the level of the third cervical vertebra (CSA-C3). Based on L3-SMI from CSA-MM, developing sarcopenic condition during RT (on-RT sarcopenia) was associated with worse progression-free survival (PFS) (p = 0.03) on multivariable analysis and a trend of correlation with overall survival (OS) was also evident (p = 0.05). According to L3-SMI derived from CSA-C3, on-RT sarcopenia was associated with worse PFS (p = 0.0096) and OS (p = 0.013) on univariate analysis; these associations were not confirmed on multivariable analysis. A significant association was reported between becoming on-RT sarcopenia and low baseline haemoglobin (p = 0.03) and the activation of nutritional counselling (p = 0.02). No significant associations were found between sarcopenia and worse RT toxicity. Our data suggest that the implementation of prompt nutritional support to prevent the onset of sarcopenia during RT could improve oncological outcomes in OPC setting.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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