scholarly journals Cross-sectional and longitudinal assessment of muscle from regular chest computed tomography scans: L1 and pectoralis muscle compared to L3 as reference in non-small cell lung cancer

2019 ◽  
Vol Volume 14 ◽  
pp. 781-789 ◽  
Author(s):  
Karin JC Sanders ◽  
Juliette HRJ Degens ◽  
Anne-Marie C Dingemans ◽  
Annemie MWJ Schols
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Pectoralis Muscle ◽  
Longitudinal Assessment ◽  
Small Cell Lung ◽  
Cross Sectional ◽  
Chest Computed Tomography ◽  
Computed Tomography Scans

scholarly journals Factors That Improve Chest Computed Tomography-Defined Sarcopenia Prognosis in Advanced Non-Small Cell Lung Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Ming Yang ◽  
Lingling Tan ◽  
Lingling Xie ◽  
Song Hu ◽  
Dan Liu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Physical Performance ◽  
Handgrip Strength ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Chest Computed Tomography ◽  
Performance Status Score

BackgroundWhether muscle strength and physical performance should be components of sarcopenia remains controversial. This study evaluated the skeletal muscle index derived from computed tomography images at the 12th thoracic vertebra level (T12 SMI), handgrip strength, performance status, and their combination for predicting overall survival in patients with advanced non-small cell lung cancer.MethodsChest computed tomography, handgrip strength measurement, and bioelectrical impedance analysis were performed. Sarcopenia was defined based on the T12 SMI alone or the T12 SMI, handgrip, and/or physical performance (i.e. Asian Working Group for Sarcopenia [AWGS]-defined sarcopenia or severe sarcopenia).ResultsOverall, 639 participants were included; 488 (76.4%) died. At baseline, 160 (25.0%), 141 (22.1%), and 42 (6.6%) patients had computed tomography-defined sarcopenia, AWGS-defined sarcopenia, and AWGS-defined severe sarcopenia, respectively. Chest computed tomography-defined sarcopenia (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.65-2.43), AWGS-defined sarcopenia (HR, 2.00; 95% CI, 1.59-2.49), and AWGS-defined severe sarcopenia (HR, 3.01; 95% CI, 2.21-4.09) were more strongly associated with poor prognosis than a performance status score ≥2 (HR, 1.37; 95% CI, 1.10-1.73).ConclusionsAdding handgrip strength and the performance status score to chest computed tomography-defined sarcopenia improved its prognostic ability. Oncological sarcopenia research should focus on muscle mass, strength, and function.

scholarly journals Tumor Response Dynamics During First-Line Pembrolizumab Therapy in Patients With Advanced Non–Small-Cell Lung Cancer

2021 ◽  
pp. 501-509
Author(s):  
Mizuki Nishino ◽  
Fangxin Hong ◽  
Biagio Ricciuti ◽  
Hiroto Hatabu ◽  
Mark M. Awad
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Tumor Burden ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Overall Response ◽  
Computed Tomography Scans

PURPOSE The objectives of the study were to characterize the tumor burden dynamics on serial computed tomography scans in patients with advanced non–small-cell lung cancer treated with first-line pembrolizumab and to identify imaging markers for prolonged overall survival (OS). MATERIALS AND METHODS Eighty-eight patients treated with first-line pembrolizumab monotherapy were evaluated on serial computed tomography scans to characterize their quantitative tumor burden during therapy. Tumor burden dynamics were studied for the association with OS. RESULTS The overall response rate was 42% (37/88), with the median tumor burden changes at the best overall response of −18.3% (range, −100.0% to +103.6%). Response rates were higher in men than in women ( P = .05) and in patients with higher programmed cell death ligand-1 expression levels ( P = .02). Tumor burden stayed below the baseline burden throughout therapy in 55 patients (63%). In an 8-week landmark analysis, patients with tumor burden below the baseline burden during the first 8 weeks of therapy had longer OS compared with patients who had ≥ 0% increase (median OS, 30.7 v 16.2 months; hazard ratio [HR] = 0.44; P = .01). In the extended Cox models, patients whose tumor burden stayed below the baseline burden throughout therapy had significantly reduced hazards of death (HR = 0.41, P = .003, univariate; HR = 0.35, P = .02, multivariate). Only one patient (1.1%) experienced pseudoprogression with initial tumor increase and subsequent tumor regression. CONCLUSION In patients with advanced non–small-cell lung cancer treated with first-line single-agent pembrolizumab, tumor burden reduction below the baseline burden during therapy was an independent marker for prolonged OS, which may serve as a practical guide for treatment decisions.

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