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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

Skeletal muscle depletion during chemotherapy has a large impact on physical function in elderly Japanese patients with advanced non–small-cell lung cancer

Authors: Tateaki Naito, Taro Okayama, Takashi Aoyama, Takuya Ohashi, Yoshiyuki Masuda, Madoka Kimura, Hitomi Shiozaki, Haruyasu Murakami, Hirotsugu Kenmotsu, Tetsuhiko Taira, Akira Ono, Kazushige Wakuda, Hisao Imai, Takuya Oyakawa, Takeshi Ishii, Shota Omori, Kazuhisa Nakashima, Masahiro Endo, Katsuhiro Omae, Keita Mori, Nobuyuki Yamamoto, Akira Tanuma, Toshiaki Takahashi

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Elderly patient with advanced cancer is one of the most vulnerable populations. Skeletal muscle depletion during chemotherapy may have substantial impact on their physical function. However, there is little information about a direct relationship between quantity of muscle and physical function. We sought to explore the quantitative association between skeletal muscle depletion, and muscle strength and walking capacity in elderly patients with advanced non–small cell lung cancer (NSCLC).

Methods

Thirty patients aged ≥70 years with advanced NSCLC (stage III-IV) scheduled to initiate first-line chemotherapy were prospectively enrolled between January 2013 and November 2014. Lumbar skeletal muscle index (LSMI, cm2/m2), incremental shuttle walking distance (ISWD, m), and hand-grip strength (HGS, kg) were assessed at baseline, and 6 ± 2 weeks (T2) and 12 ± 4 weeks (T3) after study enrollment. Associations were analyzed using linear regression.

Results

Altogether, 11 women and 19 men with a median age of 74 (range, 70–82) years were included in the study; 24 received cytotoxic chemotherapy and 6, gefitinib. Mean ± standard deviation of LSMI, ISWD and HGS were 41.2 ± 7.8 cm2/m2, 326.0 ± 127.9 m, and 29.3 ± 8.5 kg, respectively. LSMI and ISWD significantly declined from baseline to T2 and T3. HGS significantly declined from baseline to T2 and T3 only in men. Change in LSMI was significantly associated with change in HGS (β = 0.3 ± 0.1, p = 0.0127) and ISWD (β = 8.8 ± 2.4, p = 0.0005).

Conclusions

Skeletal muscle depletion accompanied with physical functional decline started in the early phase of the chemotherapy in elderly patients with advanced NSCLC. Our results suggest that there may be a need for early supportive care in these patients to prevent functional decline during chemotherapy.

Trial registration

Trial registration number: UMIN000009768
Name of registry: UMIN (University hospital Medical Information Network).
URL of registry: Date of registration: 14 January 2013.
Date of enrolment of the first participant to the trial: 23 January 2013.
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Metadata
Title
Skeletal muscle depletion during chemotherapy has a large impact on physical function in elderly Japanese patients with advanced non–small-cell lung cancer
Authors
Tateaki Naito
Taro Okayama
Takashi Aoyama
Takuya Ohashi
Yoshiyuki Masuda
Madoka Kimura
Hitomi Shiozaki
Haruyasu Murakami
Hirotsugu Kenmotsu
Tetsuhiko Taira
Akira Ono
Kazushige Wakuda
Hisao Imai
Takuya Oyakawa
Takeshi Ishii
Shota Omori
Kazuhisa Nakashima
Masahiro Endo
Katsuhiro Omae
Keita Mori
Nobuyuki Yamamoto
Akira Tanuma
Toshiaki Takahashi
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3562-4

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