1444P - Sarcopenia and acute severe toxicity in sarcoma patients treated with doxorubicin-based chemotherapy

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Complications/Toxicities of Treatment
Supportive Measures
Biological Therapy
Presenter Aurelie Comte
Citation Annals of Oncology (2014) 25 (suppl_4): iv494-iv510. 10.1093/annonc/mdu354
Authors A. Comte1, O. Huillard2, D. Biau3, A. Babinet3, J. Durand2, V. Dumaine3, F. Larousserie4, V. Audard4, J. Alexandre2, P. Anract3, F. Goldwasser2, P. Boudou Rouquette2
  • 1Medical Oncology Service, Hopital European George Pompidou, 75015 - Paris/FR
  • 2Medical Oncology, Cochin-Port Royal, 75679 - Paris/FR
  • 3Orthopedic Surgery, Cochin, 75679 - Paris/FR
  • 4Pathology, Cochin, 75679 - Paris/FR



Lean body mass (LBM) better than body surface area (BSA), predicts epirubicin's clearance and its toxicity in breast cancer patients (pts) (Prado et al, 2010). Since the dose-intensity of anthracycline-based chemotherapy may be critical in sarcoma pts, we studied whether sarcopenia was associated with the occurrence of acute severe toxicity (AT) in this population.


Sarcoma pts treated with doxorubicin-based chemotherapy and having a CT scan at the 3rd lumbar vertebrae prior chemotherapy were selected. Skeletal muscle cross-sectional area were measured and sarcopenia was defined using standardized thresholds (Antoun et al, 2010.). Acute severe toxicity was defined as any grade 4 toxicity or febrile neutropenia (FN) or grade≥3 gastrointestinal (GI) toxicity, according to the NCI-CTC occurring at 1st cycle. Sarcopenic and non-sarcopenic pts were compared (χ-2 test or Fischer's exact test for qualitative data).


42 consecutive soft tissue (n=24; 57%) and bone sarcoma (n=18; 43%) pts were eligible (57.1% males, median age 48yrs, range 22-68), and received a median doxorubicin dose of 112 mg at first cycle (range 84-148). 24 pts (57.1%) were sarcopenic at baseline. 13 (54%) of the sarcopenic patients had a normal body mass index (BMI), 11 (46%) were overweight. During the first cycle, AT were hematologic (11 pts 26.2%), FN (8 pts 19.0%), and GI toxicity (6 pts 14.3%). Sarcopenic pts had significantly more ATs (11/24 versus 3/18, p=0.04), more grade 4 hematotoxicity (9/24 versus 2/18, p=0.05), more FN (7/24 versus 1/18, p=0.05). Pts with sarcopenia and BMI< 25 kg/m2 experienced significantly more grade ≥3 GI toxicity (4/13 versus 2/29, p=0.04).


The evaluation of sarcopenia prior to doxorubicin-based chemotherapy in sarcoma patients identifies patients with high-risk of acute toxicity.


All authors have declared no conflicts of interest.