Correlation of skeletal muscle depletion with acute toxicities for cervical cancer patients undergoing concurrent chemoradiation: A prospective study

Abstract

Context: Pelvic radiation with concurrent chemotherapy is associated with toxicities that worsen the cachectic state of the patient.

Aims: : The aim of this study is to quantify skeletal muscle changes on computed tomography (CT) images helps in assessing the same which could be correlated with the toxicities.

Settings and design: The study design was s prospective study.

Subjects and methods: Forty-one patients were treated with chemoradiation followed by brachytherapy (BT) for cervical cancer. Preexternal beam and preBT CT scans were used to assess skeletal muscle index (SMI). The changes in the SMI were correlated with enteritis, dyselectrolytemia, and hematological toxicities.

Statistical analysis used: Paired t-test was used to compare pre- and post-treatment SMI. Chi-square test would be used to study the association between toxicity and SMI change.

Results: The mean SMI was 57.41 cm²/m² (42.5-73) in the preexternal beam radiotherapy (EBRT) scans and 54.5 cm²/m² (40.9-71.07) in the post-EBRT scans. Twenty-two patients (53.7%), 14 patients (34.1%), and five patients (12.2%) belonged to <5%, 5%-10%, and >10% loss in SMI groups, respectively. Grade III enteritis was seen in 31.7% of the patients, hyponatremia in 26.8% of the patients in the 4th week, and leukopenia and neutropenia were seen in 26.8% of cases in the 5^th week. Enteritis correlated significantly with the change in SMI (P = 0.047).

Conclusion: Patients with cancer cachexia are at higher risk for radiation enteritis during chemoradiation for cervical cancer.

Keywords: Cervical cancer; chemoradiation; skeletal muscle depletion.