The effect of sarcopenia on acute chemotherapy toxicity in gastrointestinal cancer patients undergoing systemic therapy

Background: We aimed to evaluate the effect of sarcopenia on tolerability of chemotherapy during systemic treatment of pts with gastrointestinal system cancer (GISC). Methods: Patients with GISC who had not previously received chemotherapy or radiotherapy were included. All of the pts muscle mass was evaluated by bioimpedance prior to the first cycle of chemotherapy, and pts who had normal muscle mass according to first bioimpedance evaluation were re-evaluated after 2-3 cycles of chemotherapy. The acute toxicities were compared in sarcopenic and non-sarcopenic pts. To define the sarcopenia results of a Turkish validation study was used (sarcopenia for male <9.2 kg/m2, female: 7.4 kg/m2). Results: A total 116 pts who had nosarcopenia in the first evaluation were included in the study population. Median age was 57 (min:26-max:76) and 2/3 of them were male (67.6%). Primary tumor locations were colorectal (51.8%), gastric (44.1%), esophagus (4.1%). Chemotherapy was given as adjuvant (46.9%), neoadjuvant (22.1%) and palliative (31%). In the second bioimpedance evaluation sarcopenia was detected in 36 (31%) pts. Basal body-mass index (BMI) evaluation of pts showed that rate of obese and overweight pts was significantly lower in sarcopenic pts compared to non-sarcopenic pts (44.4% vs 68.8%, p < 0.05). At the time of thesecond bioimpedance measurement, there was no significant difference between BMI of sarcopenic and non-sarcopenic pts. The rate of chemotherapy toxicities of the sarcopenic and non-sarcopenic group is shown in the table:Table: 1733PToxicitySarcopenic (n = 36) %Non-sarcopenic (n = 80) %pThrombocytopenia Yes, No33.3, 66.758.8, 41.30.011Neutropenia Yes, No55.6, 44.472.5, 27.50.073Anemia Yes, No63.9, 36.167.2, 32.90.73Delay of chemotherapy Yes, No27.8, 72.243.0, 57.00.11Dose reduction Yes, No28.4, 71.437.5, 62.50.35 Open table in a new tab Conclusions: In GISC pts non-sarcopenic at time of diagnosis, BMI remains unchanged after 2-3 cycles of chemotherapy. However, muscle loss had developed in 1/3 of them. Pts who developed sarcopenia had lower rates of chemotherapy-associated toxicity. The reasons for this difference should be further investigated. However, the different lipophilic and hydrophilic properties of chemotherapy agents might be one of possible explanation. Legal entity responsible for the study: Yildirim Beyazit University, Medical Oncology. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.