1601P - Relationship between CT and ultrasonography-based sarcopenia and hematologic toxicity in patients with cancer receiving chemotherapy

Background

Sarcopenia is a common condition among cancer patients. The aim of this study is to investigate the potential relationship between sarcopenia and hematologic toxicity in cancer patients by evaluating skeletal muscles with computed tomography (CT) and ultrasound (US) before chemotherapy.

Methods

A prospective cohort study was conducted on cancer patients who received anthracycline-based chemotherapy between 2018 and 2020 and had baseline abdominal CT containing L3 level for measuring skeletal muscle index (L3 SMI) and/or muscle US were included. Sex-specific cut-offs for L3 SMI were used for diagnosis of sarcopenia. Sex- and body mass index–adjusted sonographic thigh adjustment ratio (STAR) values (cut-off values 1.0 for female patients and 1.4 for male patients) were used for US assessment of sarcopenia.

Results

A total of 65 patients (14 male, 51 female) were included; 40 (61.5%) with breast cancer, 17 (26.2%) with lymphoma, and 8 (12.3%) with sarcoma. Mean age was 46.3 ± 14 years. Sarcopenia was determined in 13 patients (20%) according to CT, and in 10 patients (15.4%) according to US assessment. Regarding acute toxicity, patients with sarcopenia according to CT L3-SMI value had a significantly higher incidence of grade ≥ 3 neutropenia (39% vs 12%, p = 0.045) but similar level of thrombocytopenia (%3 vs %0, p > 0.9) after the first cycle of chemotherapy compared to non-sarcopenic patients. Patients with sarcopenia based on STAR values also had a significantly higher incidence of grade ≥ 3 neutropenia (50% vs 16%, p = 0.03) and higher incidence of grade ≥ 3 thrombocytopenia (10% vs 0%, p = 0.15) after the first cycle of chemotherapy compared to non-sarcopenic patients.

Conclusions

We found a significant association between sarcopenia diagnosed by CT and US and hematologic toxicity. Routine CT scans performed for cancer staging may help clinicians identify high-risk patients and facilitate closer monitoring of side effects and earlier introduction of supportive measures. US based assessment of sarcopenia also has high diagnostic accuracy and may predict neutropenia risk. US may serve as an easy-to-use, point of care tool for assessing sarcopenia with the advantage of repeated sequential assessment.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.