Skeletal muscle and adipose tissue changes in the first phase of treatment of pediatric solid tumors

Joffe, Lenat; Shen, Wei; Shadid, Grace; Jin, Zhezhen; Ladas, Elena J.

doi:10.1002/cam4.3584

Cited by 16 publications

(25 citation statements)

References 36 publications

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“…In accordance with the findings regarding muscle quality, the previously mentioned study in pediatric patients with a solid tumor using CT to assess body composition found no changes in IMAT and skeletal muscle density. 12 In contrast, that study found a decrease…”

Section: Discussionmentioning

confidence: 72%

Body composition of patients with neuroblastoma using computed tomography

IJpma

Lequin

Nievelstein

et al. 2021

Pediatric Blood & Cancer

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Background: Computed tomography (CT) is often used to investigate muscle and fat mass in adult patients with cancer. However, this method has rarely been used in the pediatric cancer population. The present retrospective study aimed to investigate changes in body composition using CT during treatment in children with neuroblastoma.Procedure: CT images of 29 patients with high-risk neuroblastoma were retrospectively analyzed at diagnosis and longitudinally during treatment. The cross-sectional area of skeletal muscle, intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) and skeletal muscle density at the level of the third lumbar vertebra were examined. To correct for height, cross-sectional areas were divided by height in meters squared. A linear mixed model was estimated to investigate changes in body composition over time.Results: A small increase in skeletal muscle (p = .029), skeletal muscle density (p = .002), and IMAT (p < .001) was found. Furthermore, a rapid increase in VAT (p < .001) and SAT (p = .001) was seen early during treatment with the highest volumes after six cycles of chemotherapy.Conclusions: CT scans obtained during standard care provide insight into the direction and timing of changes in skeletal muscle and different types of adipose tissue in childhood cancer patients. Future research is needed regarding the consequences of the rapid increase of VAT and SAT early during treatment.

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Section: Discussionmentioning

confidence: 72%

Body composition of patients with neuroblastoma using computed tomography

IJpma

Lequin

Nievelstein

et al. 2021

Pediatric Blood & Cancer

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“…The repeated results of search were ruled out. After screening of abstracts, 137 results were chosen for full-text analysis, of which 18 ( 25 , 33 – 49 ) met the inclusion criteria and were included in the study. A flowchart of study inclusion is presented in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Of 18 studies included in this review, 8 ( 25 , 33 – 37 , 42 , 45 ) examined the prevalence of SO and 8 ( 33 – 35 , 37 , 43 , 44 , 47 , 48 ) evaluated outcomes related to SO. Seven studies were performed in Europe ( 25 , 34 – 36 , 42 , 45 , 48 ), 5 in the United States ( 38 , 40 , 46 , 47 , 49 ), 3 in Asia ( 33 , 37 , 41 ), and 3 in South America ( 39 , 43 , 44 ). The number of participants ranged from 12 ( 46 ) to 15,392 ( 45 ).…”

Section: Resultsmentioning

confidence: 99%

“…Overall DXA (n = 8/18) ( 33 , 35 , 37 , 38 , 41 , 43 , 44 , 46 ) and analysis BIA (n = 6/18) ( 25 , 34 , 36 , 42 , 45 , 48 ) were the most commonly used body composition evaluation methods, followed by other imaging techniques (4/18) ( 40 , 46 , 47 , 49 ) and assessment of handgrip strength (HGS) using dynamometer ( 39 ). Three studies used more than one method to assess SO [BIA along with dynamometer ( 36 , 42 ) and quantitive computed tomography (QCT) in addition to DXA ( 46 )].…”

Section: Resultsmentioning

confidence: 99%

“…In the study by Joffe et al. ( 49 ), chest CT images obtained at two time points, diagnosis and first follow-up disease evaluation (6–14 weeks after initiation of therapy), of children, adolescents, and young adults who underwent treatment for a primary diagnosis of Wilms tumor, Ewing sarcoma, osteosarcoma, or rhabdomyosarcoma were used. Measurement of SM, residual lean mass (RLT), and visceral adipose tissue (VAT) was performed on single-slice images at a select anatomic landmark located in the intervertebral space between the 12th thoracic and first lumbar vertebrae (T12–L1).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Zembura

Matusik

2022

Front. Endocrinol.

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Sarcopenic obesity (SO) is defined as co-occurrence of increased fat mass and sarcopenia and may predict adverse health outcomes in the pediatric population. However, the prevalence of SO and its association with adverse health outcomes have not been well defined in children and adolescents. We systematically reviewed data on the SO definition, prevalence, and adverse outcomes in the pediatric population. A total of 18 articles retrieved from PubMed or Web of Science databases were included. Overall, there was a wide heterogeneity in the methods and thresholds used to define SO. The prevalence of SO ranged from 5.66% to 69.7% in girls, with a range between 7.2% and 81.3% in boys. Of the 8 studies that evaluated outcomes related to SO, all showed a significant association of SO with cardiometabolic outcomes, non-alcoholic fatty liver disease (NAFLD) severity, inflammation, and mental health. In conclusion, this review found that SO is highly prevalent in children and adolescents and is associated with various adverse health outcomes. Findings of this review highlight the need for the development of a consensus regarding definition, standardized evaluation methods, and age and gender thresholds for SO for different ethnicities in the pediatric population. Further studies are needed to understand the relationship between obesity and sarcopenia and SO impact on adverse health outcomes in children and adolescents.

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Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma

Wadhwa

Lim

Dai

et al. 2023

Cancer

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BackgroundStudies examining changes in skeletal muscle and adipose tissue during treatment for cancer in children, adolescents, and young adults and their effect on the risk of chemotherapy toxicity (chemotoxicity) are limited.MethodsAmong 78 patients with lymphoma (79.5%) and rhabdomyosarcoma (20.5%), changes were measured in skeletal muscle (skeletal muscle index [SMI]; skeletal muscle density [SMD]) and adipose tissue (height‐adjusted total adipose tissue [hTAT]) between baseline and first subsequent computed tomography scans at the third lumbar vertebral level by using commercially available software. Body mass index (BMI; operationalized as a percentile [BMI%ile]) and body surface area (BSA) were examined at each time point. The association of changes in body composition with chemotoxicities was examined by using linear regression.ResultsThe median age at cancer diagnosis of this cohort (62.8% male; 55.1% non‐Hispanic White) was 12.7 years (2.5–21.1 years). The median time between scans was 48 days (range, 8–207 days). By adjusting for demographics and disease characteristics, this study found that patients undergo a significant decline in SMD (β ± standard error [SE] = −4.1 ± 1.4; p < .01). No significant changes in SMI (β ± SE = −0.5 ± 1.0; p = .7), hTAT (β ± SE = 5.5 ± 3.9; p = .2), BMI% (β ± SE = 4.1 ± 4.8; p = .3), or BSA (β ± SE = −0.02 ± 0.01; p = .3) were observed. Decline in SMD (per Hounsfield unit) was associated with a greater proportion of chemotherapy cycles with grade ≥3 nonhematologic toxicity (β ± SE = 1.09 ± 0.51; p = .04).ConclusionsThis study shows that children, adolescents, and young adults with lymphoma and rhabdomyosarcoma undergo a decline in SMD early during treatment, which is associated with a risk of chemotoxicities. Future studies should focus on interventions designed at preventing the loss of muscle during treatment.Plain Language Summary We show that among children, adolescents, and young adults with lymphoma and rhabdomyosarcoma receiving chemotherapy, skeletal muscle density declines early during treatment. Additionally, a decline in skeletal muscle density is associated with a greater risk of nonhematologic chemotoxicities.

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Skeletal muscle and adipose tissue changes in the first phase of treatment of pediatric solid tumors

Cited by 16 publications

References 36 publications

Body composition of patients with neuroblastoma using computed tomography

Body composition of patients with neuroblastoma using computed tomography

Sarcopenic Obesity in Children and Adolescents: A Systematic Review

Assessment of longitudinal changes in body composition of children with lymphoma and rhabdomyosarcoma

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