Cross-sectional study of body composition measurement in cancer patients using anthropometry and medical imaging techniques
DOI:
https://doi.org/10.14306/renhyd.23.3.724Keywords:
Tomography, Radiotherapy, Body Composition, Malnutrition.Abstract
Introduction: The main purpose of this study was to diagnose body composition in cancer patients before starting radiotherapy treatment, by using classic techniques based on anthropometry and biochemical parameters, as well as including new techniques based on computed tomography (TC) images.
Material and methods: A sample of 22 patients with cancers that affect the digestive system underwent radiotherapy computed simulation which included measurements at L3 regions. Body composition was determined by using classic anthropometry, biochemical parameters and skeletal muscle mass by using Hounsfield Units (HU).
Results: Mean BMI was 65,19 (±12,72) Kg, mean BMI 23,74 (± 5,03) kg/m2, mean average of WL 15,84 (±10,87) %, mean triceps skinfolds 9,73 (± 5,08) mm and mean brachial muscle perimeter 22,81 (± 2,95) cm. In terms of lab analysis, hipoalbumin was present in 63.45% of patients. On the other hand, according to body composition measured by CT scan, patients presented a mean waist circumference 99,06 (±13,38) cm, mean MM 119,41 (±35,54) cm2, and mean SMI 71,50 (±20.57) cm2/m2; being under normal cut points in 13,64% of patients.
Conclusion: New techniques based on CT scans could be daily incorporated into clinical practice in cancer patients as an additional information of classic anthropometry and biochemical parameters, being a simple technique to perform, with low cost, reproducible and very reliable in terms of determination of body composition.
References
(1) Martin L, Senesse P, Gioulbasanis I, Antoun S, Bozzetti F, Deans C et al. Diagnostic Criteria for the Classification of Cancer-Associated Weight Loss. 2015; 33:90-9
(2) Wendrich AW, Swartz JE, Bril SI, Wegner I, De Graeffd A, Smid EJ, el al. Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer. Oral Oncol. 2017; 71:26-33
(3) Seo SH, Kim SE, Yang YK, Ryoo BY, Ryu HM, Jeong JH, et al. Association of nutritional status-related indices and chemotherapy-induced adverse events in gastric cancer patients. BMC Cancer. 2016; 16:900
(4) Curtis LJ, Bernier P, Jeejeebhoy K, Allard J, Duerksen D, Gramlich L, et al. Costs of hospital malnutrition. Clin Nutr. 2017;36:1391-1396
(5) Álvarez-Hernández J, Planas Vila M, León-Sanz M, García de Lorenzo A , Celaya-Pérez S, García-Lorda P, et al. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES® .Nutr Hosp. 2012;27:1049-1059
(6) Van den Berga MGA, Rasmussen-Conrada EE, Nispena Jaap L, Van Binsberguen J, Matthias B, Merkxc AV. A prospective study on malnutrition and quality of life in patients with head and neck cancer. Oral Oncology. 2008;44:830-837
(7) Ravasco P, Monteiro-Grillo I, Camilo ME. Does nutrition influence quality of life in cancer patients undergoing radiotherapy? Radiother Oncol. 2003;67:213-20
(8) Fearon K, Strasser F, Anker S, Bosaeus I, Bruera E, Faisinger RL, Jatoi A, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncology, The. 2011;12:489-495
(9) Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age and ageing. 2010 Jul;39:412-423
(10) Yeon Kim JL, Wie GA, Cho YA, Kim SY, Kim SM, Son KH, et al. Development and validation of a nutrition screening tool for hospitalized cancer patients. Clinical Nutrition. 2011;30:724-729
(11) Di Luzio R, Moscatiello S, Marchesini G. Role of nutrition in gastrointestinal oncological patients. European Review for Medical and Pharmacological Sciences 2010;14: 277-284
(12) Gavazzi C, Colatruglio S, Valoriani F, Mazzaferro V, Sabbatini A, Biffi R, et al. Impact of home enteral nutrition in malnourished patients with upper gastrointestinal cancer: A multicentre randomised clinical trial. EjC. 2016; 64:107-112
(13) Aversa Z, Costelli P, Muscaritoli M. Cancer-induced muscle wasting: latest findings in prevention and treatment. Ther Adv Med Oncol. 2017; 9: 369–382
(14) Goya Wannamethee S, Atkins JL. Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity. PNS. 2015;74:405-8.
(15) Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. Review ESPEN expert group recommendations for action against cancer related malnutrition. Clin Nutr. 2017; 36: 1187 – 1196.
(16) Talwar B, Donnelly R, Skelly R, Donaldson M. Nutritional management in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016; 130:32–40.
(17) Prado CM, Birdsell LA, Baracos VE. The emerging role of computerized tomography in assessing cancer cachexia. Curr Opin Support Palliat Care. 2009; 3:269-275.
(18) Mourtzakis M, Prado MC, Lieffers RJ, Reiman T, McCargar LJ, Baracos VE. A practical and precise approach to quantification of body composition in cancer patients using computered tomography images acquired during routine care. Physiol Nutr Metab 2008; 33:997-1006.
(19) Yip C, Dinkel C, Mahajan A, Siddique M, Cook JR, Goh V. Imaging body composition in cancer patients: visceral obesity, sarcopenia and sarcopenic obesity may impact on clinical outcome. Insights Imaging. 2015; 6:489-497
(20) Gomez-Perez SL, Haus JM, Sheean P, Patel B, Mar W, Chaudhry V, et al. Measuring Abdominal Circumference and Skeletal Muscle From a Single Cross-Sectional Computed Tomography Image: A Step-by-Step Guide for Clinicians Using National Institutes of Health ImageJ. JPEN J Parenter Enteral Nutr. 2016; 40:308-18
(21) Begini P, Gigante E, Antonelli G, Carbonetti F, Iannicelli E, Anania G, et al. Sarcopenia predicts reduced survival in patients with hepatocellular carcinoma at first diagnosis. Ann. Hepatol. 2017;16:107-114
(22) Barthelemy N, Streel S, Donneau AF, Coucke P, Albert A, Guillaume M. Screening for malnutrition in lung cancer patients undergoing radiotherapy. Supportive Care in Cancer. 2014;22:1531-6
(23) Garcia-Luna PP, Parejo Campos J, Pereira Cunill JL. Causas e impacto clínico de la desnutrición y caquexia en el paciente oncológico. Nutr Hosp. 2006;21:10-6
(24] Sauer AC. Malnutrition in Patients With Cancer: An Often Overlooked and Undertreated Problem. Supportive Care in Cancer. 2013;6: 23-24.
(25) Planas M, Puiggrós C, Redecillas S. Contribución del soporte nutricional a combatir la caquexia cancerosa. Nutr Hosp. 2006;21:27-36.
(26) Ma L, Poulin P, Psych C, Feldstain A, Chasen MR, Phil M. The association between malnutrition and psychological distress in patients with advanced head-and-neck cancer. Curr Oncol. 2013;20: e554–e560.
(27) Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc. 2002; 50:889-896.
(28) Prado CM, Baracos VE, McCargar LJ. Body composition as an independent determinant of 5-fluoracil – based chemotherapy toxicity, Clean Cancer Reas. 2007;13:2634-2368.
(29) Wendrich, AW, Swartz JE, Bril S, Wegner I, De Graeff I, Smid E, et al. Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer. Oral Oncol. 2017;71:26-33.
(30) Grossberg AJ, Chamchod S, Fuller CD, Mohamed ASR, Heukelom J, Eichelberger H, et al. Association of Body Composition With Survival and Locoregional Control of Radiotherapy-Treated Head and Neck Squamous Cell Carcinoma. JAMA Oncol .2016;2:782-789.
(31) Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22(3):235-9.
(32) Marín Caro MM, Gómez Candela C, Castillo Rabaneda R, Lourenço Nogueira T, García Huerta M, Loria Kohen V, et al. Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group. Nut hosp. 2008;23:458.
(33) Rubbieri G, Mossello E, Di Bari M. Techniques for the diagnosis of sarcopenia. JBMM. 2014; 11:181-184.
(34) Erlandson MC, Lorbergs AL, Mathur S, Cheung AM. Muscle analysis using pQCT, DXA and MRI. Eur J Radiol. 2016;85: 1505-11.
(35) Kim YJ, Park JW, Kim JW, Park CS, Gonzalez JPS, Lee SH, et al. Computerized Automated Quantification of Subcutaneous and Visceral Adipose Tissue From Computed Tomography Scans: Development and Validation Study. JMIR Med Inform. 2016; 4:e2.
(36) Goya Wannamethee S, Atkins JL. Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity. PNS. 2015; 74: 405–412.
(37) Morgan DJ, Bray KM. Lean body mass as a predictor of drug dosage. Implications for drug therapy. Clinical pharmacokinetics. 1994; 26:292-307.
(38) Prado CM, Maia YLM, Ormesbee M, Sawyer M, Baracos VE. Assessment of nutritional status in cancer – The relationship between body composition and pharmacokinetics. Anti-Cancer Agents Med Chem. 2013; 13:000-000
(39) Aversa Z, Costelli P, Muscaritoli M. Cancer-induced muscle wasting: latest findings in prevention and treatment. Ther Adv Med Oncol. 2017; 9: 369-382.
This journal 