Introduction:
Low muscle mass has been associated with poor functional status and lack of tolerance of chemotherapy for patients with cancer. (1) Bioelectrical impedance analysis (BIA) is a validated method for measuring body composition (2). Here we investigated whether: 1) there was a change in body composition, measured by BIA, over 3 cycles of chemotherapy, and 2) pre-chemotherapy muscle status was associated with chemotherapy tolerance.
Methods:
A prospective observational study for patients with solid tumours starting a new line of chemotherapy. Patients had body composition, handgrip strength test and nutritional status assessed prior to starting treatment and before the subsequent three cycles. Descriptive tests were used for patient characteristics and repeated measure ANOVA to examine body composition changes (% of fat free mass (FFM), % of fat mass (FM) and body weight (BW)). Low muscle mass was defined as per recommended thresholds outlined by Cederholm (2019). (3)
Results:
Sixty patients were recruited: 35 female (58%), half with early-stage cancer; most common tumor types were breast (35%), colorectal (25%). Median age was 59 years (IQR 26-82). The majority (88%) received chemotherapy only. At baseline, almost 1/3 of patients (14/50) were malnourished; 42% (n 25) had reduced muscle mass, 4 (7%) had low handgrip strength. There was no significant difference in BW, %FFM, or %FM over time. Baseline body composition was not associated with tolerance of the first cycle of treatment. There was variation in the assessment period (9 to 29 days) mainly due to different chemotherapy regimens and delays in chemotherapy.
Conclusion:
No changes were observed in body composition over 3 cycles of treatment. Baseline body composition was not associated with treatment tolerance. This could be due to the study duration being short, variation in assessment period, heterogeneity of the sample, and/or BIA scale not sensitive enough to detect changes.