Change of skeletal muscle mass and associated factors during radiotherapy and chemoradiotherapy in patients with head and neck squamous cell carcinoma

Abstract

Background and purpose

The aim is to investigate whether lumbar skeletal muscle index (LSMI) decreases during treatment of head and neck squamous cell carcinoma (HNSCC) patients, and which pre-treatment variables are associated with change.

Materials and methods

The LSMI before and during treatment was assessed using MRI scans of HNSCC patients treated with radiotherapy (RT) or chemoradiotherapy (CRT). Mixed models assessed LSMI change and pre-treatment covariates (i.e. age, BMI, tumor characteristics and treatment type).

Results

In 63 patients the LSMI decreased from 40.56 cm²/m² to 39.96 cm²/m² (p trend = 0.008) on average. The LSMI of CRT patients decreased more than the LSMI of RT patients, but this was not significant (40.85–39.63 cm²/m² vs. 40.37 to 40.19 cm²/m²; p-interaction = 0.052). No effects of pre-treatment covariates on the LSMI trend over time were observed.

Conclusion

LSMI decreased during treatment in HNSCC patients, which was not related to pre-treatment variables, but seemed slightly larger for CRT patients than RT patients.