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Background <p>Low skeletal muscle mass and impaired muscle quality (myosteatosis) have been associated with poor outcomes in cancer patients. This study aimed to evaluate the impact of pre-therapeutic low muscle mass and myosteatosis on chemoradiotherapy (CRT)-induced toxicity and survival outcomes in patients with non-resectable pancreatic cancer (PC).</p> Methods <p>In this retrospective study, pre-therapeutic CT scans were used to measure muscle mass/density. Low muscle mass was defined as a skeletal muscle index &lt;38.5 cm²/m² (women) and &lt;52.4 cm²/m² (men), and myosteatosis as a mean psoas density &lt;41 HU if BMI &lt; 25 kg/m² or &lt;33 HU if BMI &gt; 25 kg/m². Adverse effects were collected per week (W) of treatment. Dose-limiting toxicity (DLT) was defined as any toxicity leading to dose reduction, treatment delays or permanent discontinuation.</p> Results <p>Among the 85 included patients, 75 (88.2%) and 18 (22.2%) had pre-therapeutic low muscle mass and myosteatosis, respectively. Only 12 patients (14.1%) experienced DLT. Patients with low muscle mass developed significantly more toxicities at W2 (<i>p</i> = 0.013) and W5 (<i>p</i> = 0.026), notably more nausea (<i>p</i> = 0.037) and anemia (<i>p</i> = 0.004). Low muscle mass was associated with poorer overall survival (HR 4.41 [1.50–12.94], <i>p</i> = 0.007) in multivariate Cox analysis, while myosteatosis was not associated with CRT toxicities, DLT and overall survival (<i>p</i> = 0.408).</p> Conclusion <p>Patients with low muscle mass experienced more toxicities and poorer outcomes during CRT for non-resectable PC.</p>

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Impact of low muscle mass and myosteatosis on treatment toxicity and survival outcomes in non-resectable pancreatic cancer patients treated with chemoradiotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月5日

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  • Marine Perrier,
  • Marine Fontaine,
  • Eric Bertin,
  • Claire Carlier,
  • Damien Botsen,
  • Manel Djelouah,
  • Eric François,
  • Philippe Guilbert,
  • Angélique Saint,
  • Florian Slimano,
  • Paolo Torielli,
  • Mathias Brugel,
  • Olivier Bouché

摘要

Background

Low skeletal muscle mass and impaired muscle quality (myosteatosis) have been associated with poor outcomes in cancer patients. This study aimed to evaluate the impact of pre-therapeutic low muscle mass and myosteatosis on chemoradiotherapy (CRT)-induced toxicity and survival outcomes in patients with non-resectable pancreatic cancer (PC).

Methods

In this retrospective study, pre-therapeutic CT scans were used to measure muscle mass/density. Low muscle mass was defined as a skeletal muscle index <38.5 cm²/m² (women) and <52.4 cm²/m² (men), and myosteatosis as a mean psoas density <41 HU if BMI < 25 kg/m² or <33 HU if BMI > 25 kg/m². Adverse effects were collected per week (W) of treatment. Dose-limiting toxicity (DLT) was defined as any toxicity leading to dose reduction, treatment delays or permanent discontinuation.

Results

Among the 85 included patients, 75 (88.2%) and 18 (22.2%) had pre-therapeutic low muscle mass and myosteatosis, respectively. Only 12 patients (14.1%) experienced DLT. Patients with low muscle mass developed significantly more toxicities at W2 (p = 0.013) and W5 (p = 0.026), notably more nausea (p = 0.037) and anemia (p = 0.004). Low muscle mass was associated with poorer overall survival (HR 4.41 [1.50–12.94], p = 0.007) in multivariate Cox analysis, while myosteatosis was not associated with CRT toxicities, DLT and overall survival (p = 0.408).

Conclusion

Patients with low muscle mass experienced more toxicities and poorer outcomes during CRT for non-resectable PC.