Abstract
PurposeSarcopenia has been identified as an important prognostic factor for patients with cancer. This study aimed at exploring the potential associations between a 6-month physical activity intervention and muscle characteristics, sarcopenia, oxidative stress and toxicities in patients with metastatic breast cancer.MethodsWomen newly diagnosed with metastatic breast cancer (N = 49) participated in an unsupervised, personalized, 6-month physical activity intervention with activity tracker. Computerized tomography images at the third lumbar vertebra were analysed at baseline, three months and six months to assess sarcopenia (muscle mass index < 40 cm2/m2) and muscle quality (poor if muscle attenuation < 37.8 Hounsfield Units). Oxidative markers included plasma antioxidant enzymes (catalase, glutathione peroxidase and superoxide dismutase activities), prooxidant enzymes (NADPH oxidase and myeloperoxidase activities) and oxidative stress damage markers (advanced oxidation protein products, malondialdehyde (MDA) and DNA oxidation.ResultsAt baseline 53% (mean age 55 years (SD 10.41)) were sarcopenic and 75% had poor muscle quality. Muscle cross sectional area, skeletal muscle radiodensity, lean body mass remained constant over the six months (p = 0.75, p = 0.07 and p = 0.75 respectively), but differed significantly between sarcopenic and non-sarcopenic patients at baseline and 6-months. Sarcopenic patients at baseline were more likely to have an increase of MDA (p = 0.02) at 6 months. Being sarcopenic during at least one moment during the 6-month study was associated with a higher risk of developing severe toxicities (grade > 2) (p = 0.02).ConclusionsThis study suggests potential benefits of physical activity for maintenance of muscle mass. Sarcopenia can alter many parameters and disturb the pro and antioxidant balance.
Highlights
About 5% of breast cancers are metastatic at diagnosis and 20–30% of localized breast cancer become secondarily metastatic [1, 2]
Among the 49 metastatic breast cancer patients enrolled in the study, 47 had an available abdominal Computed tomography (CT) scan at baseline
A total of 35 patients (74.5%) had a poor muscle quality represented by a Skeletal muscle density (SMD) < 37.8HU (Table 1): 16 among nonsarcopenic patients (72.7%) and 19 patients among sarcopenic patients (76%) had a poor muscle quality (SMD < 37.8HU) (Table 1)
Summary
About 5% of breast cancers are metastatic at diagnosis and 20–30% of localized breast cancer become secondarily metastatic [1, 2]. The literature has suggested associations between body composition and risk of treatment toxicities according to National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI-CTCAE; Version 5.0) at early stages of cancer [16, 17], in advanced cancer [12, 13, 18,19,20,21,22] and in breast cancer [7, 8, 22,23,24,25,26] Several of these studies have demonstrated that the decrease in muscle mass was associated with an interruption of chemotherapy or a reduction in dose [21, 27, 28]. The balance between reducing the risk of toxicity inherent to treatments and maintaining the efficacy of anticancer drugs raises the need to prevent sarcopenia by enhancing body composition
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