{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:13:39Z","timestamp":1787836419946,"version":"build-2784847793"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The dose-limiting effect of CT-assessed low skeletal muscle mass (LSMM) measured at the level of the third cervical vertebra has been found in head and neck cancer patients receiving high-dose cisplatin chemoradiotherapy. The aim of this study was to investigate the predictive factors for dose-limiting toxicities (DLTs) using low-dose weekly chemoradiotherapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Head and neck cancer patients receiving definite chemoradiotherapy with weekly 40 mg\/m<jats:sup>2<\/jats:sup> body surface area (BSA) cisplatin or paclitaxel 45 mg\/m<jats:sup>2<\/jats:sup> BSA and carboplatin AUC2 were consecutively included and retrospectively analysed. Skeletal muscle mass was assessed using the muscle surface at the level of the third cervical vertebra in pretherapeutic CT scans. After stratification for LSMM DLT, acute toxicities and feeding status during the treatment were examined.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Dose-limiting toxicity was significantly higher in patients with LSMM receiving cisplatin weekly chemoradiotherapy. For paclitaxel\/carboplatin, no significance regarding DLT and LSMM could be found. Patients with LSMM had significantly more dysphagia before treatment, although feeding tube placement before treatment was equal in patients with and without LSMM.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>LSMM is a predictive factor for DLT in head and neck patients treated with low-dose weekly chemoradiotherapy with cisplatin. For paclitaxel\/carboplatin, further research must be carried out.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0282015","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T18:59:13Z","timestamp":1677005953000},"page":"e0282015","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Low skeletal muscle mass is predictive of dose-limiting toxicities in head and neck cancer patients undergoing low-dose weekly cisplatin chemoradiotherapy"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6972-0899","authenticated-orcid":true,"given":"Jan-Niklas","family":"Becker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rn","family":"Wichmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Sonnhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Christiansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Bruns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"issue":"1","key":"pone.0282015.ref001","doi-asserted-by":"crossref","first-page":"E2151","DOI":"10.1002\/hed.24026","article-title":"Cumulative cisplatin dose in concurrent chemoradiotherapy for head and neck cancer: A systematic review","volume":"38","author":"P Strojan","year":"2016","journal-title":"Head Neck"},{"key":"pone.0282015.ref002","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.radonc.2009.04.014","article-title":"Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients","volume":"92","author":"J-P Pignon","year":"2009","journal-title":"Radiother Oncol"},{"key":"pone.0282015.ref003","doi-asserted-by":"crossref","first-page":"3757","DOI":"10.1007\/s00405-017-4687-4","article-title":"The impact of cumulative dose of cisplatin on outcome of patients with head and neck squamous cell carcinoma","volume":"274","author":"A Al-Mamgani","year":"2017","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"pone.0282015.ref004","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ejca.2015.12.030","article-title":"Prognostic value of sarcopenia in adults with solid tumours: A meta-analysis and systematic review","volume":"57","author":"SS Shachar","year":"2016","journal-title":"Eur J Cancer"},{"key":"pone.0282015.ref005","doi-asserted-by":"crossref","first-page":"5298","DOI":"10.1016\/j.clnu.2021.08.023","article-title":"Low skeletal muscle mass is a predictor of treatment related toxicity in oncologic patients. 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