Journal
ORAL ONCOLOGY
Volume 61, Issue -, Pages 62-69Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.oraloncology.2016.08.012
Keywords
Body composition; Lean body mass; Computed tomography; Height- and weight-based mathematical formulas; Head and neck cancer; Radiotherapy
Categories
Funding
- National Institutes of Health (NIH)/National Institute for Dental and Craniofacial Research [1R01DE025248-01/R56DE025248-01]
- NIH/National Cancer Institute (NCI) Head and Neck Specialized Programs of Research Excellence (SPORE) Developmental Research Program Award [P50CA097007-10]
- Paul Calabresi Clinical Oncology Program Award [K12 CA088084-06]
- National Science Foundation (NSF), Division of Mathematical Sciences, Joint NIH/NSF Initiative on Quantitative Approaches to Biomedical Big Data (QuBBD) Grant (NSF) [1557679]
- General Electric Healthcare/MD Anderson Center for Advanced Biomedical Imaging In-Kind Award
- Elekta AB/MD Anderson Department of Radiation Oncology Seed Grant
- Center for Radiation Oncology Research (CROR) at MD Anderson Cancer Center
- MD Anderson Institutional Research Grant (IRG) Program
- Elekta AB
- National Institutes of Health (NIH)/National Cancer Institute (NCI) Cancer Center Support (Core) Grant [CA016672]
- Koningin Wilhemina Fonds/Rene Vogels Foundation grant
- Division Of Mathematical Sciences
- Direct For Mathematical & Physical Scien [1557679] Funding Source: National Science Foundation
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Objectives: We undertook a challenge to determine if one or more height-weight formula(e) can be clinically used as a surrogate for direct CT-based imaging assessment of body composition before and after radiotherapy for head and neck cancer (HNC) patients, who are at risk for cancer-and therapy-associated cachexia/sarcopenia. Materials and methods: This retrospective single-institution study included 215 HNC patients, treated with curative radiotherapy between 2003 and 2013. Height/weight measures were tabulated. Skeletal muscle mass was contoured on pre-and post-treatment CT at the L3 vertebral level. Three common lean body mass (LBM) formulae (Hume, Boer, and James) were calculated, and compared to CT assessment at each time point. Results: 156 patients (73%) had tumors arising in the oropharynx and 130 (61%) received concurrent chemotherapy. Mean pretreatment body mass index (BMI) was 28.5 +/- 4.9 kg/m(2) in men and 27.8 +/- 8 kg/m(2) in women. Mean post-treatment BMI were 26.2 +/- 4.4 kg/m(2) in men, 26 +/- 7.5 kg/m(2) in women. Mean CT-derived LBM decreased from 55.2 +/- 11.8 kg pre-therapy to 49.27 +/- 9.84 kg postradiation. Methods comparison revealed 95% limit of agreement of +/- 12.5-13.2 kg between CT and height-weight formulae. Post-treatment LBM with the three formulae was significantly different from CT (p < 0.0001). In all instances, no height-weight formula was practically equivalent to CT within +/- 5 kg. Conclusion: Formulae cannot accurately substitute for direct quantitative imaging LBM measurements. We therefore recommend CT-based LBM assessment as a routine practice of head and neck cancer patient body composition. (C) 2016 Elsevier Ltd. All rights reserved.
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