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1. European Quality Markers in Oral and Maxillofacial Surgery Specialty Training: Defining Standards

Author

Puladi, Behrus, Stephanus Brandsma, Dirk, Tavakoli, Milad, Celep, Emre, Taylor, Richard, Amiraliye, Kenan, Apse, Ingus, Aragón Niño, Íñigo, Balint, Gergely, Barbulescu, Vlad, Becker, Philipp, Berens, Jeff, Birk, Anže, Bondi, Thomas, Bouland, Cyril, Britton, Danielle, Brus Madsen, Frey, Chargi, Najiba, Chatzopoulos, Georgios, Chrysostomidis, Anestis, Croonenborghs, Tomas-Marijn, Di Giorgio, Danilo, Domi, Mjellma, Filippi, Andrea, Gruber, Lennart, Hosamaldin, Sayf, Isufi, Renato, Kaczynski, Filip, Kivimaa, Tiiu, Knutsen, Guro, Kull, Kristina, Lackova, Eva, Lamçe, Ledja, Lillestik, Taur, Louizakis, Alexandros, Mehrjoh, Nima, Moors, Jasper, Neiva-Sousa, Manuel, Ochyra, Dorota, Öztürk Muhtar, Merve, Paasché, Agnès, Roshni Patel, Nutan, Prikule, Ilze, Puiu, Tudor, Ramadani, Visar, Rašić, Mario, Rios, Olina, Romanova, Anna, Rooyer, Jacelyn, Sexton, Paul, Sommacal, Adelita, Stankevičius, Dominykas, Thiem, Daniel, Toivari, Miika, Urhan Güçlü, Şeydanur, Watson, Lara, and Lemma, Francesco

Published
2024
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5. Systematic review with meta-analysis: branched-chain amino acid supplementation in liver disease

Author

Afdeling Dietetiek, Cancer, Epi Kanker Team C, MS Hoofd-Hals Chirurgische Oncologie, VS-DIGD, MS MDL 1, Infection & Immunity, van Dijk, Anne M, Bruins Slot, Alexandra S, Portincasa, Piero, Siegerink, Sebastiaan N, Chargi, Najiba, Verstraete, Carina J R, Bruijne, Joep de, Vleggaar, Frank P, van Erpecum, Karel J, Afdeling Dietetiek, Cancer, Epi Kanker Team C, MS Hoofd-Hals Chirurgische Oncologie, VS-DIGD, MS MDL 1, Infection & Immunity, van Dijk, Anne M, Bruins Slot, Alexandra S, Portincasa, Piero, Siegerink, Sebastiaan N, Chargi, Najiba, Verstraete, Carina J R, Bruijne, Joep de, Vleggaar, Frank P, and van Erpecum, Karel J

Published
2023

6. The association between skeletal muscle measures and chemotherapy‐induced toxicity in non‐small cell lung cancer patients

Author

de Jong, Corine, Chargi, Najiba, Herder, Gerarda J M, van Haarlem, Simone W A, van der Meer, Femke, van Lindert, Anne S R, Ten Heuvel, Alexandra, Brouwer, Jan, de Jong, Pim A, Devriese, Lot A, Huitema, Alwin D R, Egberts, Toine C G, de Bree, Remco, Deneer, Vera H M, Pharmacoepidemiology and Clinical Pharmacology, and Afd Pharmacoepi & Clinical Pharmacology

Subjects
Male, Lung Neoplasms, Antineoplastic Agents, Middle Aged, Body composition, Chemotherapy-induced toxicity, Skeletal muscle mass, Non-small cell lung cancer, Carcinoma, Non-Small-Cell Lung, Physiology (medical), Humans, Female, Orthopedics and Sports Medicine, Prospective Studies, Muscle, Skeletal, Platinum-based chemotherapy, Follow-Up Studies
Abstract

BACKGROUND: Chemotherapy-induced toxicities frequently occur in non-small cell lung cancer (NSCLC) patients treated with platinum-based chemotherapy. Low skeletal muscle mass (SMM) has been associated with a higher incidence of toxicities for several types of cancers and cytostatics. The aim of this study was to evaluate the association between skeletal muscle measures and chemotherapy-induced toxicity in a large cohort of NSCLC patients. METHODS: A multicentre prospective follow-up study (PGxLUNG, NTR number NL5373610015) in NSCLC patients was conducted. Included were patients diagnosed with NSCLC (stage II-IV) treated with first-line platinum-based (cisplatin or carboplatin) chemotherapy of whom pretreatment imaging was available. Skeletal muscle area (SMA) segmentation was performed on abdominal imaging at the level of the third lumbar vertebra (L3). SMA at the level of L3 was corrected for squared height (m2 ) to yield the lumbar skeletal muscle mass index (LSMI). Skeletal muscle density (SMD) was calculated as the mean Hounsfield Unit (HU) of the segmented SMA. SMM and SMD were categorized as low, intermediate, and high, based on LSMI and mean HU tertiles, respectively. Chemotherapy-induced toxicity was scored using CTCAE v4.03 and categorized into haematological (anaemia, leukocytopenia, neutropenia, and thrombocytopenia), non-haematological (nephrotoxicity, neurotoxicity, and esophagitis), and dose-limiting toxicity (DLT) (treatment switch, delay, de-escalation, discontinuation, or hospitalization). The relationship between SMM, SMD, and toxicities was assessed with logistic regression modelling taking into account potential confounders like gender and body mass index (BMI). RESULTS: In total, 297 patients (male n = 167, median age 64 years) were included. Haematological toxicity grade 3/4 was experienced in 36.6% (n = 108) of the patients, 24.6% (n = 73) experienced any non-haematological toxicity grade ≥2, and 55.6% (n = 165) any DLT. Multivariate logistic regression analysis showed that low SMM (ORadj 2.41, 95% CI 1.31-4.45, P = 0.005) and age at diagnosis >65 years (ORadj 1.76, 95% CI 1.07-2.90, P = 0.025) were statistically significantly associated with overall haematological toxicity grade 3/4. No statistically significant associations were found between low SMM or low SMD and non-haematological toxicities. Low SMM (ORadj 2.23, 95% CI 1.23-4.04, P = 0.008) and high SMD (ORadj 0.41, 95% CI 0.23-0.74, P = 0.003) were statistically significantly associated with a higher respectively lower risk of DLT. CONCLUSIONS: Non-small cell lung cancer patients with pretreatment low SMM are at significant higher risk for haematological toxicities grade 3/4 and DLT. NSCLC patients with high SMD are at significant lower risk for DLT. Further studies should be aimed to investigate whether platinum dosing based on skeletal muscle measurements and/or improvement of pretreatment SMM/SMD could reduce the risk of toxicity without compromising efficacy.

Published
2022

10. The association between skeletal muscle measures and chemotherapy-induced toxicity in non-small cell lung cancer patients

Author

Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, de Jong, Corine, Chargi, Najiba, Herder, Gerarda J M, van Haarlem, Simone W A, van der Meer, Femke, van Lindert, Anne S R, Ten Heuvel, Alexandra, Brouwer, Jan, de Jong, Pim A, Devriese, Lot A, Huitema, Alwin D R, Egberts, Toine C G, de Bree, Remco, Deneer, Vera H M, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, de Jong, Corine, Chargi, Najiba, Herder, Gerarda J M, van Haarlem, Simone W A, van der Meer, Femke, van Lindert, Anne S R, Ten Heuvel, Alexandra, Brouwer, Jan, de Jong, Pim A, Devriese, Lot A, Huitema, Alwin D R, Egberts, Toine C G, de Bree, Remco, and Deneer, Vera H M

Published
2022

11. Association of low skeletal muscle mass and systemic inflammation with surgical complications and survival after microvascular flap reconstruction in patients with head and neck cancer

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Chargi, Najiba, Breik, Omar, Forouzanfar, Tymour, Martin, Timothy, Praveen, Prav, Idle, Matthew, Parmar, Satyesh, de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, Cancer, Chargi, Najiba, Breik, Omar, Forouzanfar, Tymour, Martin, Timothy, Praveen, Prav, Idle, Matthew, Parmar, Satyesh, and de Bree, Remco

Published
2022

12. The association between skeletal muscle measures and chemotherapy-induced toxicity in non-small cell lung cancer patients

Author

Apotheek Onderzoek, Cancer, Arts Assistenten Longziekten, Longziekten, Infection & Immunity, Researchgr. Systems Radiology, Circulatory Health, Regenerative Medicine and Stem Cells, MS Medische Oncologie, Apotheek O&O&O, Brain, Child Health, MS Hoofd-Hals Chirurgische Oncologie, Apotheek Klinische Farmacie, de Jong, Corine, Chargi, Najiba, Herder, Gerarda J.M., van Haarlem, Simone W.A., van der Meer, Femke, van Lindert, Anne S.R., ten Heuvel, Alexandra, Brouwer, Jan, de Jong, Pim A., Devriese, Lot A., Huitema, Alwin D.R., Egberts, Toine C.G., de Bree, Remco, Deneer, Vera H.M., Apotheek Onderzoek, Cancer, Arts Assistenten Longziekten, Longziekten, Infection & Immunity, Researchgr. Systems Radiology, Circulatory Health, Regenerative Medicine and Stem Cells, MS Medische Oncologie, Apotheek O&O&O, Brain, Child Health, MS Hoofd-Hals Chirurgische Oncologie, Apotheek Klinische Farmacie, de Jong, Corine, Chargi, Najiba, Herder, Gerarda J.M., van Haarlem, Simone W.A., van der Meer, Femke, van Lindert, Anne S.R., ten Heuvel, Alexandra, Brouwer, Jan, de Jong, Pim A., Devriese, Lot A., Huitema, Alwin D.R., Egberts, Toine C.G., de Bree, Remco, and Deneer, Vera H.M.

Published
2022

13. Cut-off values for low skeletal muscle mass at the level of the third cervical vertebra (C3) in patients with head and neck cancer

Author

MS Hoofd-Hals Chirurgische Oncologie, MS Radiotherapie, Cancer, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Chargi, Najiba, Bril, Sandra I., Smid, Ernst J., de Jong, Pim A., De Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, MS Radiotherapie, Cancer, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Chargi, Najiba, Bril, Sandra I., Smid, Ernst J., de Jong, Pim A., and De Bree, Remco

Published
2022

14. Image-based analysis of skeletal muscle mass predicts cisplatin dose-limiting toxicity in patients with locally advanced head and neck cancer

Author

MS Hoofd-Hals Chirurgische Oncologie, Other research (not in main researchprogram), MS Radiotherapie, Cancer, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Apotheek O&O&O, MS Medische Oncologie, Chargi, Najiba, Bashiri, Fereshta, Wendrich, Anne W., Smid, Ernst J., de Jong, Pim A., Huitema, Alwin D.R., Devriese, Lot A., de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, Other research (not in main researchprogram), MS Radiotherapie, Cancer, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Apotheek O&O&O, MS Medische Oncologie, Chargi, Najiba, Bashiri, Fereshta, Wendrich, Anne W., Smid, Ernst J., de Jong, Pim A., Huitema, Alwin D.R., Devriese, Lot A., and de Bree, Remco

Published
2022

15. Masseter muscle parameters can function as an alternative for skeletal muscle mass assessments on cross-sectional imaging at lumbar or cervical vertebral levels

Author

MS Hoofd-Hals Chirurgische Oncologie, MS Radiologie, Brain, Circulatory Health, Cancer, MS Radiotherapie, van Heusden, Hugo C., Chargi, Najiba, Dankbaar, Jan Willem, Smid, Ernst J., de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, MS Radiologie, Brain, Circulatory Health, Cancer, MS Radiotherapie, van Heusden, Hugo C., Chargi, Najiba, Dankbaar, Jan Willem, Smid, Ernst J., and de Bree, Remco

Published
2022

16. The association of cisplatin pharmacokinetics and skeletal muscle mass in patients with head and neck cancer: The prospective PLATISMA study

Author

MS Hoofd-Hals Chirurgische Oncologie, MS Medische Oncologie, Cancer, Apotheek O&O&O, Chargi, Najiba, Molenaar-Kuijsten, Laura, Huiskamp, Laura F J, Devriese, Lot A, de Bree, Remco, Huitema, Alwin D R, MS Hoofd-Hals Chirurgische Oncologie, MS Medische Oncologie, Cancer, Apotheek O&O&O, Chargi, Najiba, Molenaar-Kuijsten, Laura, Huiskamp, Laura F J, Devriese, Lot A, de Bree, Remco, and Huitema, Alwin D R

Published
2022

17. Arterial calcification on preoperative computed tomography imaging as a risk factor for pharyngocutaneous fistula formation after total laryngectomy

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, MS KNO, Other research (not in main researchprogram), MS Radiotherapie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Bril, Sandra I, Chargi, Najiba, Pezier, Thomas F, Tijink, Bernard M, Braunius, Weibel W, Smid, Ernst J, de Jong, Pim A, de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, Cancer, MS KNO, Other research (not in main researchprogram), MS Radiotherapie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Bril, Sandra I, Chargi, Najiba, Pezier, Thomas F, Tijink, Bernard M, Braunius, Weibel W, Smid, Ernst J, de Jong, Pim A, and de Bree, Remco

Published
2022

18. The association of pretreatment low skeletal muscle mass with chemotherapy dose-limiting toxicity in patients with head and neck cancer undergoing primary chemoradiotherapy with high-dose cisplatin

Author

MS Hoofd-Hals Chirurgische Oncologie, MS Medische Oncologie, Cancer, Bril, Sandra I., Al-Mamgani, Abrahim, Chargi, Najiba, Remeijer, Peter, Devriese, Lot A., de Boer, Jan Paul, de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, MS Medische Oncologie, Cancer, Bril, Sandra I., Al-Mamgani, Abrahim, Chargi, Najiba, Remeijer, Peter, Devriese, Lot A., de Boer, Jan Paul, and de Bree, Remco

Published
2022

19. Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

Author

MS Hoofd-Hals Chirurgische Oncologie, Cancer, Karsten, Rebecca T., Chargi, Najiba, van der Molen, Lisette, van Son, Rob J.J.H., de Bree, Remco, Al-Mamgani, Abrahim, de Boer, Jan P., Hilgers, Frans J.M., van den Brekel, Michiel W.M., Smeele, Ludi E., Stuiver, Martijn M., MS Hoofd-Hals Chirurgische Oncologie, Cancer, Karsten, Rebecca T., Chargi, Najiba, van der Molen, Lisette, van Son, Rob J.J.H., de Bree, Remco, Al-Mamgani, Abrahim, de Boer, Jan P., Hilgers, Frans J.M., van den Brekel, Michiel W.M., Smeele, Ludi E., and Stuiver, Martijn M.

Published
2022

20. Systematic review with meta‐analysis: Branched‐chain amino acid supplementation in liver disease.

Author

van Dijk, Anne M., Bruins Slot, Alexandra S., Portincasa, Piero, Siegerink, Sebastiaan N., Chargi, Najiba, Verstraete, Carina J. R., de Bruijne, Joep, Vleggaar, Frank P., and van Erpecum, Karel J.

Subjects
BRANCHED chain amino acids, LIVER diseases, PARACENTESIS, AMINO acids, DIETARY supplements, ESOPHAGEAL varices, NUTRITIONAL status
Abstract

Background: Dietary supplementation with branched‐chain amino acids (BCAA) is often used in cirrhotic patients to improve nutritional status. We wanted to explore the evidence for BCAA supplementation in chronic liver disease. Methods: We searched MEDLINE and EMBASE for studies with BCAA supplementation with the presence of a disease‐control group (placebo or no intervention) using search terms 'liver cirrhosis', 'hepatocellular carcinoma', 'branched chain amino acids' and relevant synonyms. Risk of bias was assessed using ROBINS‐I and RoB 2.0 tools. Meta‐analyses were performed with a random‐effects model. Results were reported following EQUATOR guidelines. Results: Of 3378 studies screened by title and abstract, 54 were included (34 randomized controlled trials, 5 prospective case–control studies, 13 retrospective case–control studies: in total 2308 patients BCAA supplementation, 2876 disease‐controls). Risk of bias was high/serious for almost all studies. According to meta‐analyses, long‐term (at least 6 months) BCAA supplementation in cirrhotic patients significantly improved event‐free survival (p =.008; RR.61 95% CI.42–.88) and tended to improve overall survival (p =.05; RR.58 95% CI.34–1.00). Two retrospective studies suggested the beneficial effects during sorafenib for hepatocellular carcinoma. Available studies reported no beneficial effects or contradictory results of BCAA after other specific therapeutic interventions (resection or radiological interventions for hepatocellular carcinoma, liver transplantation, paracentesis or variceal ligation). No convincing beneficial effects of BCAA supplementation on liver function, nutritional status or quality of life were found. No study reported serious side effects of BCAA. Conclusions: Prophylactic BCAA supplementation appears safe and might improve survival in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Feasibility of assessment of skeletal muscle mass on a single cross-sectional image at the level of the fourth thoracic vertebra

Author

MS Hoofd-Hals Chirurgische Oncologie, Brain, MS Radiologie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Cancer, Arts Assistenten CTC, Zorgeenheid Traumatologie, van Heusden, Hugo C., Swartz, Justin E., Chargi, Najiba, de Jong, Pim A., van Baal, Mark C.P.M., Wegner, Inge, de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, Brain, MS Radiologie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Cancer, Arts Assistenten CTC, Zorgeenheid Traumatologie, van Heusden, Hugo C., Swartz, Justin E., Chargi, Najiba, de Jong, Pim A., van Baal, Mark C.P.M., Wegner, Inge, and de Bree, Remco

Published
2021

30. Patterns, predictors, and prognostic value of skeletal muscle mass loss in patients with locally advanced head and neck cancer undergoing cisplatin-based chemoradiotherapy

Author

MS Hoofd-Hals Chirurgische Oncologie, KNO Onderzoek, MS Radiotherapie, Cancer, MS Radiologie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, MS Medische Oncologie, Chargi, Najiba, Wegner, Inge, Markazi, Navid, Smid, Ernst, de Jong, Pim, Devriese, Lot, de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, KNO Onderzoek, MS Radiotherapie, Cancer, MS Radiologie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, MS Medische Oncologie, Chargi, Najiba, Wegner, Inge, Markazi, Navid, Smid, Ernst, de Jong, Pim, Devriese, Lot, and de Bree, Remco

Published
2021

31. Sarcopenia measured with handgrip strength and skeletal muscle mass to assess frailty in older patients with head and neck cancer

Author

MS Hoofd-Hals Chirurgische Oncologie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Cancer, MS Geriatrie, Meerkerk, Christiaan D A, Chargi, Najiba, de Jong, Pim A, van den Bos, Frederiek, de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, Researchgr. Systems Radiology, Circulatory Health, Infection & Immunity, Regenerative Medicine and Stem Cells, Cancer, MS Geriatrie, Meerkerk, Christiaan D A, Chargi, Najiba, de Jong, Pim A, van den Bos, Frederiek, and de Bree, Remco

Published
2021

32. Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

Author

Karsten, Rebecca T., primary, Chargi, Najiba, additional, van der Molen, Lisette, additional, van Son, Rob J. J. H., additional, de Bree, Remco, additional, Al-Mamgani, Abrahim, additional, de Boer, Jan P., additional, Hilgers, Frans J. M., additional, van den Brekel, Michiel W. M., additional, Smeele, Ludi E., additional, and Stuiver, Martijn M., additional

Published
2021
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35. The predictive value of low skeletal muscle mass assessed on cross-sectional imaging for anti-cancer drug toxicity: A systematic review and meta-analysis

Author

MS Hoofd-Hals Chirurgische Oncologie, MS Medische Oncologie, Cancer, Epi Infectieziekten, Epidemiology & Health Economics, JC onderzoeksprogramma Kanker, Apotheek O&O&O, Huiskamp, Laura F.J., Chargi, Najiba, Devriese, Lot A., May, Anne M., Huitema, Alwin D.R., de Bree, Remco, MS Hoofd-Hals Chirurgische Oncologie, MS Medische Oncologie, Cancer, Epi Infectieziekten, Epidemiology & Health Economics, JC onderzoeksprogramma Kanker, Apotheek O&O&O, Huiskamp, Laura F.J., Chargi, Najiba, Devriese, Lot A., May, Anne M., Huitema, Alwin D.R., and de Bree, Remco

Published
2020

37. Arterial calcification on preoperative computed tomography imaging as a risk factor for pharyngocutaneous fistula formation after total laryngectomy.

Author

Bril, Sandra I., Chargi, Najiba, Pezier, Thomas F., Tijink, Bernard M., Braunius, Weibel W., Smid, Ernst J., de Jong, Pim A., and de Bree, Remco

Subjects
LARYNGECTOMY, ARTERIAL calcification, COMPUTED tomography, SURGICAL complications, FISTULA
Abstract

Background: Research in esophageal surgery showed that computed tomography (CT) assessed arterial calcification (AC) is associated with postoperative complications. We investigated the association between AC and pharyngocutaneous fistula (PCF) formation after laryngectomy. Methods: This was a retrospective cohort study of patients undergoing laryngectomy. AC was scored at 10 different anatomical locations on CT imaging, blinded for PCF occurrence. Association with PCF was investigated using logistic regression. Results: The 224 patients were included; 62 (27.7%) developed a PCF. Moderate to severe AC was widespread in patients undergoing TL; 7.1% of patients had at most mild AC, of whom 1 experienced a PCF (p = 0.05). A higher cumulative calcification score was associated with PCF in univariable (OR 1.11, p = 0.04) and multivariable analysis (OR 1.14, p = 0.05). Conclusion: AC is widespread in patients undergoing laryngectomy and its burden is associated with PCF. Extensive AC on preoperative imaging may be considered a risk factor for PCF. [ABSTRACT FROM AUTHOR]

Published
2022
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38. The association of pretreatment low skeletal muscle mass with chemotherapy dose‐limiting toxicity in patients with head and neck cancer undergoing primary chemoradiotherapy with high‐dose cisplatin.

Author

Bril, Sandra I., Al‐Mamgani, Abrahim, Chargi, Najiba, Remeijer, Peter, Devriese, Lot A., de Boer, Jan Paul, and de Bree, Remco

Subjects
HEAD & neck cancer, CHEMORADIOTHERAPY, MUSCLE mass, SKELETAL muscle, CARDIAC pacing, CISPLATIN, CANCER chemotherapy
Abstract

Background: Low skeletal muscle mass (SMM) is an adverse prognostic factor for chemotherapy dose‐limiting toxicity (CDLT). In patients with locally advanced head and neck squamous cell carcinoma (HNSCC) undergoing chemoradiotherapy (CRT), low SMM is a predictor for CDLT. We aimed to validate these findings. Methods: Consecutive LA‐HNSCC patients treated with primary CRT with high‐dose cisplatin were retrospectively included. SMM was measured on pre‐treatment CT‐imaging. A cumulative cisplatin dose below 200 mg/m2 was defined as CDLT. Results: One hundred and fifty three patients were included; 37 (24.2%) experienced CDLT, and 84 had low SMM (54.9%). Patients with low SMM experienced more CDLT than patients with normal SMM (35.7% vs. 10.1%, p < 0.01). Low SMM (OR 3.99 [95% CI 1.56–10.23], p = 0.01) and an eGFR of 60–70 ml/min (OR 5.40 [95% CI 1.57–18.65], p < 0.01) were predictors for CDLT. Conclusion: Pre‐treatment low SMM is associated with CDLT in LA‐HNSCC patients treated with primary CRT. Routine SMM assessment may allow for CDLT risk assessment and treatment optimization. [ABSTRACT FROM AUTHOR]

Published
2022
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39. The association between skeletal muscle measures and chemotherapy‐induced toxicity in non‐small cell lung cancer patients

Author

Jong, Corine, Chargi, Najiba, Herder, Gerarda J.M., Haarlem, Simone W.A., Meer, Femke, Lindert, Anne S.R., Heuvel, Alexandra, Brouwer, Jan, Jong, Pim A., Devriese, Lot A., Huitema, Alwin D.R., Egberts, Toine C.G., Bree, Remco, and Deneer, Vera H.M.

Abstract

Chemotherapy‐induced toxicities frequently occur in non‐small cell lung cancer (NSCLC) patients treated with platinum‐based chemotherapy. Low skeletal muscle mass (SMM) has been associated with a higher incidence of toxicities for several types of cancers and cytostatics. The aim of this study was to evaluate the association between skeletal muscle measures and chemotherapy‐induced toxicity in a large cohort of NSCLC patients. A multicentre prospective follow‐up study (PGxLUNG, NTR number NL5373610015) in NSCLC patients was conducted. Included were patients diagnosed with NSCLC (stage II–IV) treated with first‐line platinum‐based (cisplatin or carboplatin) chemotherapy of whom pretreatment imaging was available. Skeletal muscle area (SMA) segmentation was performed on abdominal imaging at the level of the third lumbar vertebra (L3). SMA at the level of L3 was corrected for squared height (m2) to yield the lumbar skeletal muscle mass index (LSMI). Skeletal muscle density (SMD) was calculated as the mean Hounsfield Unit (HU) of the segmented SMA. SMM and SMD were categorized as low, intermediate, and high, based on LSMI and mean HU tertiles, respectively. Chemotherapy‐induced toxicity was scored using CTCAE v4.03 and categorized into haematological (anaemia, leukocytopenia, neutropenia, and thrombocytopenia), non‐haematological (nephrotoxicity, neurotoxicity, and esophagitis), and dose‐limiting toxicity (DLT) (treatment switch, delay, de‐escalation, discontinuation, or hospitalization). The relationship between SMM, SMD, and toxicities was assessed with logistic regression modelling taking into account potential confounders like gender and body mass index (BMI). In total, 297 patients (male n= 167, median age 64 years) were included. Haematological toxicity grade 3/4 was experienced in 36.6% (n= 108) of the patients, 24.6% (n= 73) experienced any non‐haematological toxicity grade ≥2, and 55.6% (n= 165) any DLT. Multivariate logistic regression analysis showed that low SMM (ORadj 2.41, 95% CI 1.31–4.45, P= 0.005) and age at diagnosis >65 years (ORadj 1.76, 95% CI 1.07–2.90, P= 0.025) were statistically significantly associated with overall haematological toxicity grade 3/4. No statistically significant associations were found between low SMM or low SMD and non‐haematological toxicities. Low SMM (ORadj 2.23, 95% CI 1.23–4.04, P= 0.008) and high SMD (ORadj 0.41, 95% CI 0.23–0.74, P= 0.003) were statistically significantly associated with a higher respectively lower risk of DLT. Non‐small cell lung cancer patients with pretreatment low SMM are at significant higher risk for haematological toxicities grade 3/4 and DLT. NSCLC patients with high SMD are at significant lower risk for DLT. Further studies should be aimed to investigate whether platinum dosing based on skeletal muscle measurements and/or improvement of pretreatment SMM/SMD could reduce the risk of toxicity without compromising efficacy.

Published
2022
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