{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:48:08Z","timestamp":1791218888668,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chemotherapy\u2010induced toxicities frequently occur in non\u2010small cell lung cancer (NSCLC) patients treated with platinum\u2010based chemotherapy. Low skeletal muscle mass (SMM) has been associated with a higher incidence of toxicities for several types of cancers and cytostatics. The aim of this study was to evaluate the association between skeletal muscle measures and chemotherapy\u2010induced toxicity in a large cohort of NSCLC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A multicentre prospective follow\u2010up study (PGxLUNG, NTR number NL5373610015) in NSCLC patients was conducted. Included were patients diagnosed with NSCLC (stage II\u2013IV) treated with first\u2010line platinum\u2010based (cisplatin or carboplatin) chemotherapy of whom pretreatment imaging was available. Skeletal muscle area (SMA) segmentation was performed on abdominal imaging at the level of the third lumbar vertebra (L3). SMA at the level of L3 was corrected for squared height (m\n                      <jats:sup>2<\/jats:sup>\n                      ) to yield the lumbar skeletal muscle mass index (LSMI). Skeletal muscle density (SMD) was calculated as the mean Hounsfield Unit (HU) of the segmented SMA. SMM and SMD were categorized as low, intermediate, and high, based on LSMI and mean HU tertiles, respectively. Chemotherapy\u2010induced toxicity was scored using CTCAE v4.03 and categorized into haematological (anaemia, leukocytopenia, neutropenia, and thrombocytopenia), non\u2010haematological (nephrotoxicity, neurotoxicity, and esophagitis), and dose\u2010limiting toxicity (DLT) (treatment switch, delay, de\u2010escalation, discontinuation, or hospitalization). The relationship between SMM, SMD, and toxicities was assessed with logistic regression modelling taking into account potential confounders like gender and body mass index (BMI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 297 patients (male\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0167, median age 64\u00a0years) were included. Haematological toxicity grade 3\/4 was experienced in 36.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0108) of the patients, 24.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a073) experienced any non\u2010haematological toxicity grade \u22652, and 55.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0165) any DLT. Multivariate logistic regression analysis showed that low SMM (ORadj 2.41, 95% CI 1.31\u20134.45,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.005) and age at diagnosis &gt;65\u00a0years (ORadj 1.76, 95% CI 1.07\u20132.90,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.025) were statistically significantly associated with overall haematological toxicity grade 3\/4. No statistically significant associations were found between low SMM or low SMD and non\u2010haematological toxicities. Low SMM (ORadj 2.23, 95% CI 1.23\u20134.04,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.008) and high SMD (ORadj 0.41, 95% CI 0.23\u20130.74,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.003) were statistically significantly associated with a higher respectively lower risk of DLT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010small cell lung cancer patients with pretreatment low SMM are at significant higher risk for haematological toxicities grade 3\/4 and DLT. NSCLC patients with high SMD are at significant lower risk for DLT. Further studies should be aimed to investigate whether platinum dosing based on skeletal muscle measurements and\/or improvement of pretreatment SMM\/SMD could reduce the risk of toxicity without compromising efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.12967","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T03:27:31Z","timestamp":1647574051000},"page":"1554-1564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["The association between skeletal muscle measures and chemotherapy\u2010induced toxicity in non\u2010small cell lung cancer patients"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0746-5057","authenticated-orcid":false,"given":"Corine","family":"de Jong","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy St. Antonius Hospital  Nieuwegein the Netherlands"},{"name":"Department of Clinical Pharmacy University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najiba","family":"Chargi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology, Division of Imaging and Oncology Center University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerarda J.M.","family":"Herder","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Meander Medical Center  Amersfoort the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone W.A.","family":"van Haarlem","sequence":"additional","affiliation":[{"name":"Department of Pulmonology St. Antonius Hospital  Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"van der Meer","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Diakonessenhuis  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4072-2441","authenticated-orcid":false,"given":"Anne S.R.","family":"van Lindert","sequence":"additional","affiliation":[{"name":"Department of Pulmonology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"ten Heuvel","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Groene Hart Hospital  Gouda the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Rivierenland Hospital  Tiel the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-6854","authenticated-orcid":false,"given":"Pim A.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Imaging and Oncology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lot A.","family":"Devriese","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1939-4639","authenticated-orcid":false,"given":"Alwin D.R.","family":"Huitema","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University Medical Center Utrecht  Utrecht the Netherlands"},{"name":"Department of Pharmacy &amp; 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