Previous studies have reported that sarcopenia is associated with higher mortality rate in nonmetastatic breast cancer. Moreover, there exists some evidence suggesting that sarcopenia may increase the toxicity of anti-cancer agents such as epirubicine and taxanes. However, the impact of sarcopenia on the toxicity due to EC or TC regimen, one of the most common perioperative chemotherapy for breast cancer, is not well documented.
To address this issue, we retrospectively examined a total of 128 women with breat cancer who received EC or TC regimen for neoadjuvant or adjuvant chemotherapy at Kurashiki Central Hospital between January 2013 and March 2017. Male patinets and metastatic patients were excluded. The relationship between sarcopenia and toxicity of chemotherapy was investigated. In this study, sarcopenia was defined as skeletal mass index (SMI) <40 cm2/m2; SMI was obtained from the skeletal muscle cross-sectional area measured by computed tomography at the third lumbar vertebra. Laboratory adverse events were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. Dose limiting toxicity (DLT) was defined as any toxicity that required chemotherapy dose reduction and/or discontinuation.
The baseline characteristics of the enrolled patients were as follows: age, 56.5 ± 11.8; height, 155.9 ± 5.6 cm; weight, 55.5 ± 9.2 kg; SMI, 47.1 ± 7.1 cm2/m2. Eighty-two patients received EC regimen, and 10 (12.2%) of them were sarcopenic. Compared to non-sarcopenic patients, patients with sarcopenia had grade 3–4 labolatory adverse events more frequently (70.0% vs 22.2%, p = 0.004). The frequency of DLT was not significantly different between two groups. Among 41 patients who received TC regimen, 7 patients (17.1%) were sarcopenic. Sarcopenia was not associated with the frequency of either grade 3–4 labolatory adverse events or DLT due to TC regimen.
In our study, sarcopenia was associated with higher rate of grade 3–4 labolatory adverse events due to perioperative EC chemotherapy for breast cancer. However, further studies are necessary to draw a conclusion on this topic.
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All authors have declared no conflicts of interest.