Meijin Yue, Shuqin Deng, Gaowa Daleng, Feng Chen, Jun Zhao, Ying Jiang, Jiaxuan Li, Jiayuan Guo, Yalong Han, Zhengyu Li, Gaowa Jin, Quanfu Li
Progressive loss of skeletal muscle-related body composition parameters during nab-PTX-based chemotherapy was accompanied by increased CIPN severity. CIPN-H was associated with poorer OS, but this association should be interpreted cautiously because of potential confounding by disease severity and treatment intensity. These findings support the importance of assessing body composition and implementing interventions targeting sarcopenia to reduce the risk of CIPN.
OBJECTIVE: This prospective study aimed to assess the association between dynamic changes in the L3 skeletal muscle index (L3SMI) and chemotherapy-induced peripheral neuropathy (CIPN) in patients receiving albumin-bound paclitaxel (nab-PTX)-based chemotherapy, and examine the impact of sarcopenia and CIPN on survival outcomes.
METHODS: Patients with malignancies scheduled to receive nab-PTX-based chemotherapy were enrolled. Nutritional status, body composition assessed by bioelectrical impedance analysis, and L3SMI measured using computed tomography were assessed at baseline and after three chemotherapy cycles. CIPN was assessed using the Patient Neurotoxicity Questionnaire after the first and third cycles. Patients were stratified according to baseline sarcopenia status and CIPN severity (high-grade, CIPN-H ≥ grade C; low-grade, CIPN-L < grade C).
RESULTS: Among the 152 enrolled patients, 56 completed all assessments. After three chemotherapy cycles, L3SMI decreased significantly from 32.77 to 31.93 cm²/m² (p = 0.049). CIPN severity increased over the course of treatment. The incidence of CIPN-H increased significantly from 10.71% to 39.29% (p < 0.001). The incidence of CIPN-H increased from 10.71% to 39.29% after three chemotherapy cycles. This increase was observed in both patients with and without sarcopenia, whereas the between-group difference after three cycles was not statistically significant. Median overall survival was significantly shorter in patients with CIPN-H (13 months) than in those with CIPN-L (24 months).
CONCLUSION: Progressive loss of skeletal muscle-related body composition parameters during nab-PTX-based chemotherapy was accompanied by increased CIPN severity. CIPN-H was associated with poorer OS, but this association should be interpreted cautiously because of potential confounding by disease severity and treatment intensity. These findings support the importance of assessing body composition and implementing interventions targeting sarcopenia to reduce the risk of CIPN.