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Erschienen in: Supportive Care in Cancer 2/2017

15.09.2016 | Original Article

Weight loss versus muscle loss: re-evaluating inclusion criteria for future cancer cachexia interventional trials

verfasst von: Eric J. Roeland, Joseph D. Ma, Sandahl H. Nelson, Tyler Seibert, Sean Heavey, Carolyn Revta, Andrea Gallivan, Vickie E. Baracos

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2017

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Abstract

Purpose

Participation in cancer cachexia clinical trials requires a defined weight loss (WL) over time. A loss in skeletal muscle mass, measured by cross-sectional computed tomography (CT) image analysis, represents a possible alternative. Our aim was to compare WL versus muscle loss in patients who were screened to participate in a cancer cachexia clinical trial.

Methods

This was a single-center, retrospective analysis in metastatic colorectal cancer patients screened for an interventional cancer cachexia trial requiring a ≥5 % WL over the preceding 6 months. Concurrent CT images obtained as part of standard oncology care were analyzed for changes in total muscle and fat (visceral, subcutaneous, and total).

Results

Of patients screened (n = 36), 3 (8 %) enrolled in the trial, 17 (47 %) were excluded due to insufficient WL (<5 %), 3 (8 %) were excluded due to excessive WL (>20 %), and 16 (44 %) met inclusion criteria for WL. Patients who met screening criteria for WL (5–20 %) had a mean ± SD of 7.7 ± 8.7 % muscle loss, 24.4 ± 37.5 % visceral adipose loss, 21.6 ± 22.3 % subcutaneous adipose loss, and 22.1 ± 24.7 % total adipose loss. Patients excluded due to insufficient WL had 2 ± 6.4 % muscle loss, but a gain of 8.5 ± 39.8 % visceral adipose, and 4.2 ± 28.2 % subcutaneous adipose loss and 0.8 ± 28.4 % total adipose loss. Of the patients excluded due to WL <5 % (n = 17), 7 (41 %) had a skeletal muscle loss >5 %.

Conclusions

Defining cancer cachexia by WL over time may be limited as it does not capture skeletal muscle loss. Cross-sectional CT body composition analysis may improve early detection of muscle loss and patient participation in future cancer cachexia clinical trials.
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Metadaten
Titel
Weight loss versus muscle loss: re-evaluating inclusion criteria for future cancer cachexia interventional trials
verfasst von
Eric J. Roeland
Joseph D. Ma
Sandahl H. Nelson
Tyler Seibert
Sean Heavey
Carolyn Revta
Andrea Gallivan
Vickie E. Baracos
Publikationsdatum
15.09.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 2/2017
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3402-0

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