ASPO Abstracts
Associations of Muscle and Lean Mass with Relative Dose Intensity and Adverse Events among Patients with Nonmetastatic Colon Cancer: Findings of CT, DXA, and D3-Creatine Dilution
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2023
Abstract Body:
PURPOSE: The impact of muscle and lean mass on relative dose intensity (RDI) and adverse events is not well understood for colon cancer patients, and assessing muscle and lean mass with multiple techniques may provide insight. METHODS: Using an NCI-sponsored trial of resistance training (FORCE), we assessed 1) cross-sectional area (CSA) of skeletal muscle at L3 from computed tomography (CT); 2) appendicular lean mass (ALM) from dual-energy X-ray absorptiometry (DXA); and 3) total body skeletal muscle mass using D3-creatine (D3Cr) dilution among 178 patients with nonmetastatic colon cancer. Not every patient undertook all three techniques at the baseline visit, but clinicopathological factors of patients with CT (N=170), DXA (N=162), and D3Cr (N=118) groups were comparable. We standardized each measurement by its sex-specific standard deviation (SD). The primary outcome was reduced RDI (RDI <85%). The secondary outcome was the number of moderate/severe adverse events (grade ≥2) during each cycle of chemotherapy. We estimated the associations of CT CSA, DXA ALM, and D3Cr muscle mass (per SD increase) with reduced RDI using logistic regression, and number of adverse events using generalized estimating equations for repeated measures based on regimen duration. All models were adjusted for age, sex, height, regimen, and randomization arms. RESULTS: Of 178 patients, the mean (SD) age was 55.2 (12.9) years, and 94 (52.8%) were male. Ninety-three (52.2%) experienced reduced RDI, and the mean (SD) number of adverse events was 1.4 (1.7) per cycle. Increased CT CSA and DXA ALM were significantly associated with lower risk of reduced RDI (odds ratios [OR]: 0.59 [95% CI: 0.41, 0.85] for CT CSA and 0.57 [95% CI: 0.38, 0.84] for DXA ALM). The inverse association was also observed for D3Cr muscle mass (OR: 0.77 [95% CI: 0.48, 1.25]) but was not significant. Increased muscle and lean mass were not significantly associated with the changes in the number of adverse events (relative change: 9% [95% CI: -8%, 30%] for CT CSA; 9% [95% CI: -6%, 27%] for DXA ALM; -1% [95% CI: -17%, 20%] for D3Cr muscle mass). CONCLUSIONS: In this study of patients with nonmetastatic colon cancer, higher muscle and lean mass were associated with improved chemotherapy completion but not adverse events
Keywords: Muscle; Dose Reduction; Drug Toxicity