Impact of relative cisplatin dose to skeletal muscle mass on adverse events in patients with head and neck cancer undergoing chemoradiotherapy.
Oncologist
; 2024 Jul 09.
Article
en En
| MEDLINE
| ID: mdl-38979778
ABSTRACT
BACKGROUND:
Chemoradiotherapy (CRT) with high-dose cisplatin (CDDP) is the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). Although dosing is based on body surface area (BSA), some patients experience CDDP-related adverse events (AEs). We aimed to evaluate the impact of relative CDDP dose to skeletal muscle mass (SMM) on chemotherapy-associated AEs in patients with HNSCC undergoing CRT with high-dose CDDP. MATERIALS ANDMETHODS:
We retrospectively analyzed data of patients who underwent CRT with high-dose CDDP (80-100 mg/m2, triweekly) between 2010 and 2023. SMM was measured as the cross-sectional muscle area at the third cervical vertebra (C3-SMM) using computed tomography; the skeletal muscle index (SMI) was defined as SMM normalized by squared height. The CDDP index was defined as the prescribed CDDP dose divided by SMI. CDDP-related AEs were assessed during the first cycle using Common Terminology Criteria for Adverse Events v5.0.RESULTS:
Overall, 306 patients were identified. The CDDP index cutoff value best associated with gradeâ ≥â 3 AEs was 10.312. Gradeâ ≥â 3 hematological toxicities exhibited stronger association with high CDDP index value than with low CDDP index value (26.9% vs 16.3%, Pâ =â .033). Multivariate analysis revealed that high CDDP index value and creatinine clearanceâ <â 70 mL/minute were predictive factors for gradeâ ≥â 3 AEs (odds ratio [OR] 2.55, Pâ =â .008; OR 3.68, Pâ =â .002, respectively).CONCLUSION:
The CDDP index based on C3-SMM was an independent predictive factor for gradeâ ≥â 3 CDDP-related AEs. C3-SMM is potentially more useful than BSA for determining the optimal CDDP dose in patients with HNSCC.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Oncologist
Asunto de la revista:
NEOPLASIAS
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón