Abstract
PurposeThis study aims to investigate the predictive value of low skeletal muscle mass (SMM) for cetuximab dose-limiting toxicity (DLT) and its prognostic value in head and neck squamous cell carcinoma (HNSCC) patients treated with concomitant cetuximab and radiotherapy.MethodsPatients diagnosed with HNSCC and treated with primary or adjuvant concomitant cetuximab and radiotherapy were included. Clinical and demographic variables were retrospectively retrieved and SMM was measured at the level of the third cervical vertebra using pre-treatment diagnostic computed tomography or magnetic resonance imaging. An optimal cut-off value for low SMM was determined based on the lowest log-likelihood associated with cetuximab DLT. A multivariate linear regression model was used to determine predictive factors for cetuximab DLT. The prognostic value of low SMM for disease-free and overall survival was analyzed using Kaplan–Meier curves.ResultsThe optimal cut-off value for low SMM as a predictor of cetuximab DLT was an LSMI ≤ 45.2 cm2/m2. Of the 91 included patients, 74.7% had low SMM and 30.8% experienced cetuximab DLT. At multivariate analysis, low SMM had no predictive value for DLT (OR 0.83; 95% CI 0.27–2.56; p = 0.74). The Kaplan–Meier curve demonstrated that patients with low SMM had significantly lower overall survival (Log Rank χ2 = 5.87; p = 0.02).ConclusionLow SMM is highly prevalent in HNSCC patients treated with concomitant cetuximab and radiotherapy. Low SMM has no predictive value for cetuximab DLT in HNSCC patients. Low SMM is probably not a prognostic factor for overall survival in highly selected HNSCC patients treated with concomitant cetuximab and radiotherapy and unfit for platin-based chemotherapy.
Highlights
Head and neck cancer is the sixth most common cancer, with over 600,000 new cases annually worldwide [1]
The cut-off value best associated with the presence of cetuximab dose-limiting toxicity (DLT) was lumbar skeletal muscle index (LSMI) ≤ 45.2 cm2/m2
This study demonstrated that low skeletal muscle mass (SMM) has a high prevalence in head and neck squamous cell carcinoma (HNSCC) patients with 74.7% of the patients included in this study
Summary
Head and neck cancer is the sixth most common cancer, with over 600,000 new cases annually worldwide [1]. Locoregionally advanced disease is present in up to 60% of patients [1]. Advanced-stage head and neck squamous cell carcinoma (HNSCC) is generally treated with surgery plus adjuvant radiotherapy with or without cisplatin chemotherapy or, as primary treatment, concomitant cisplatin chemotherapy and radiotherapy with salvage surgery in reserve for residual disease or recurrence [1]. Cisplatin dose-limiting toxicity (DLT) includes, among others, bone marrow depression, ototoxicity, and nephrotoxicity [3]. This can cause treatment delay, dose reduction, and possible failure to complete treatment as well as decreased quality of life [3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
