Assessment of nutritional status in cancer--the relationship between body composition and pharmacokinetics.

Several nutritional assessment tools have been used in oncology settings to monitor nutritional status and its associated prognostic significance. Body composition is fundamental for the assessment of nutritional status. Recently, the use of accurate and precise body composition tools has significantly added to the value of nutritional assessment in this clinical setting. Computerized tomography (CT) is an example of a technique which provides state-of-the-art assessment of body composition. With use of CT images, a great variability in body composition of cancer patients has been identified even in people with identical body weight or body mass index. Severe muscle depletion (sarcopenia) has emerged as a prevalent body composition phenotype which is predictive of poor functional status, shorter time to tumor progression, shorter survival, and higher incidence of dose-limiting toxicity. Variability in body composition of cancer patients may be a source of disparities in the metabolism of cytotoxic agents. Future clinical trials investigating dose reductions in patients with sarcopenia and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

[1]  M. Winget,et al.  Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery , 2012, British Journal of Cancer.

[2]  O. Mir,et al.  Sarcopenia Predicts Early Dose-Limiting Toxicities and Pharmacokinetics of Sorafenib in Patients with Hepatocellular Carcinoma , 2012, PloS one.

[3]  V. Baracos,et al.  Evaluation of the Clinical Relevance of Body Composition Parameters in Patients With Cancer Metastatic to the Liver Treated With Hepatic Arterial Infusion Chemotherapy , 2012, Nutrition and cancer.

[4]  V. Baracos,et al.  Body Composition, Symptoms, and Survival in Advanced Cancer Patients Referred to a Phase I Service , 2012, PloS one.

[5]  Vickie E. Baracos,et al.  The advantages and limitations of cross-sectional body composition analysis , 2011, Current opinion in supportive and palliative care.

[6]  Paula Ravasco,et al.  Definition and classification of cancer cachexia: an international consensus. , 2011, The Lancet. Oncology.

[7]  C. Pichard,et al.  Would you buy a new tool to improve your practice? , 2011, Current opinion in clinical nutrition and metabolic care.

[8]  L. Birdsell,et al.  Low body mass index and sarcopenia associated with dose-limiting toxicity of sorafenib in patients with renal cell carcinoma. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[9]  Tony Reiman,et al.  Body composition in patients with non-small cell lung cancer: a contemporary view of cancer cachexia with the use of computed tomography image analysis. , 2010, The American journal of clinical nutrition.

[10]  L. Mccargar,et al.  An exploratory study of body composition as a determinant of epirubicin pharmacokinetics and toxicity , 2010, Cancer Chemotherapy and Pharmacology.

[11]  L. Birdsell,et al.  The emerging role of computerized tomography in assessing cancer cachexia , 2009, Current opinion in supportive and palliative care.

[12]  Lisa Martin,et al.  Sarcopenia in an Overweight or Obese Patient Is an Adverse Prognostic Factor in Pancreatic Cancer , 2009, Clinical Cancer Research.

[13]  L. Mccargar,et al.  Sarcopenia as a Determinant of Chemotherapy Toxicity and Time to Tumor Progression in Metastatic Breast Cancer Patients Receiving Capecitabine Treatment , 2009, Clinical Cancer Research.

[14]  Tony Reiman,et al.  A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care. , 2008, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[15]  R. Roubenoff.  Excess baggage: sarcopenia, obesity, and cancer outcomes. , 2008, The Lancet. Oncology.

[16]  Tony Reiman,et al.  Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: a population-based study. , 2008, The Lancet. Oncology.

[17]  Tony Reiman,et al.  Body Composition as an Independent Determinant of 5-Fluorouracil–Based Chemotherapy Toxicity , 2007, Clinical Cancer Research.

[18]  V. Baracos.  Cancer-associated cachexia and underlying biological mechanisms. , 2006, Annual review of nutrition.

[19]  M. Nishino,et al.  Effects of oral 5-fluorouracil drugs on hepatic fat content in patients with colon cancer. , 2005, Academic radiology.

[20]  Peter Daneryd,et al.  Body composition and time course changes in regional distribution of fat and lean tissue in unselected cancer patients on palliative care—Correlations with food intake, metabolism, exercise capacity, and hormones , 2005, Cancer.

[21]  Zhao Chen.  Body Composition and Cancer , 2005 .

[22]  R. Roubenoff.  Sarcopenic obesity: the confluence of two epidemics. , 2004, Obesity research.

[23]  Mark J. Ratain,et al.  Body Surface Area as a Determinant of Pharmacokinetics and Drug Dosing , 2001, Investigational New Drugs.

[24]  N. Thatcher,et al.  Changes in body composition in men and women with advanced nonsmall cell lung cancer (NSCLC) undergoing chemotherapy. , 2003, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[25]  N. Aaronson,et al.  Effect of a protein and energy dense n-3 fatty acid enriched oral supplement on loss of weight and lean tissue in cancer cachexia: a randomised double blind trial , 2003, Gut.

[26]  E. Ferrazzí,et al.  Relationships between body composition parameters and fluorouracil pharmacokinetics. , 2002, British journal of clinical pharmacology.

[27]  H. Gurney,et al.  How to calculate the dose of chemotherapy , 2002, British Journal of Cancer.

[28]  D. Walsh,et al.  Assessment of nutritional status and prognosis in advanced cancer: interleukin-6, C-reactive protein, and the prognostic and inflammatory nutritional index , 2002, Supportive Care in Cancer.

[29]  N. Pavlakis,et al.  The predictive value of body protein for chemotherapy‐induced toxicity , 2000, Cancer.

[30]  M. Ratain.  Body-surface area as a basis for dosing of anticancer agents: science, myth, or habit? , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[31]  A. Aslani,et al.  Changes in body composition during adjuvant chemotherapy for breast cancer. , 1998, Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine.

[32]  S. Heymsfield,et al.  Human Body Composition , 1996 .

[33]  L. Grochow,et al.  Should anticancer drug doses be adjusted in the obese patient? , 1995, Journal of the National Cancer Institute.

[34]  J. Zalcberg,et al.  Lean body mass, body surface area and epirubicin kinetics. , 1994, Anti-cancer drugs.

[35]  D. Morgan,et al.  Lean Body Mass as a Predictor of Drug Dosage , 1994, Clinical pharmacokinetics.

[36]  J. Kehayias,et al.  The meaning and measurement of lean body mass. , 2009, Nutrition reviews.

[37]  K. Kudsk,et al.  The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutrition support. , 1991, Journal of the American College of Nutrition.

[38]  R. Gibson.  Principles of Nutritional Assessment , 1990 .

[39]  Mosteller Rd.  Simplified Calculation of Body-Surface Area , 1987 .

[40]  Y. Ingenbleek,et al.  A prognostic inflammatory and nutritional index scoring critically ill patients. , 1985, International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition.

[41]  K. Rai,et al.  Compartmental body composition of cancer patients by measurement of total body nitrogen, potassium, and water. , 1981, Metabolism: clinical and experimental.

[42]  Joseph R. Bertino,et al.  Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. , 1980, The American journal of medicine.

[43]  E. Rosato,et al.  Prognostic nutritional index in gastrointestinal surgery. , 1980, American journal of surgery.