Risk of Sarcopenia and Gastrointestinal Toxicity of Older Patients Undergoing Chemotherapy

Authors

  • Hellba Karts Maria Silva Universidade Federal de Pernambuco, Hospital das Clínicas de Pernambuco. Recife (PE), Brasil. https://orcid.org/0000-0003-2880-8426
  • Lilian de Souza Cavalcante Universidade Federal de Pernambuco, Hospital das Clínicas de Pernambuco. Recife (PE), Brasil. https://orcid.org/0000-0002-1887-8917
  • Giovanna Andrade Souza Almeida Universidade Federal de Pernambuco, Departamento de Nutrição. Recife (PE), Brasil. https://orcid.org/0000-0002-3836-3363
  • Jarson Pedro da Costa Pereira Universidade Federal de Pernambuco, Departamento de Nutrição. Recife (PE), Brasil. https://orcid.org/0000-0001-5412-6467
  • Marcella Campos Lima Luz Universidade Federal de Pernambuco, Hospital das Clínicas de Pernambuco. Recife (PE), Brasil. https://orcid.org/0000-0001-9226-1387

DOI:

https://doi.org/10.32635/2176-9745.RBC.2024v70n2.4606

Keywords:

Sarcopenia/diet therapy, Aged, Neoplasms/epidemiology, Nutritional Status/drug effects

Abstract

Introduction: Sarcopenia is a condition associated with poor prognosis, including the risk for worse gastrointestinal toxicity in older patients with cancer undergoing chemotherapy treatment. Objective: Evaluate the association between the risk of sarcopenia and gastrointestinal toxicity in older patients undergoing chemotherapy. Method: Observational study with cross-sectional data collection involving 60 older patients diagnosed with solid tumors, sampled by convenience, undergoing exclusive or combined chemotherapy regimen. Risk of sarcopenia was assessed using the SARC-F and SARC-CalF questionnaires. Malnutrition diagnosis was evaluated by the Mini Nutritional Assessment short form (MNA-SF). Results: Among the patients included, the risk of sarcopenia (SARC-F) was observed in 15%. Using SARC-CalF, this number increased to 33.3%. It was noticed that higher SARC-F scores were independently associated with a greater number of symptoms related to gastrointestinal toxicity. Furthermore, higher SARC-F scores (indicating higher risk) were associated with lower handgrip strength and lower MNA-SF scores. Higher SARC-CalF scores were associated with lower handgrip strength and lower MNA-SF scores as well. Conclusion: The findings suggest that SARC-F could be utilized as a guiding tool for interventions to improve muscle condition, potentially mitigating the elevated incidence of chemotherapy-related gastrointestinal symptoms..

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References

Peixoto FC. Três ensaios sobre os impactos econômicos do envelhecimento populacional no Brasil [tese na Internet]. Porto Alegre: Puc Rio Grade do Sul; 2019. [acesso 2023 nov 3]. Disponível em: https://tede2.pucrs.br/tede2/handle/tede/8769

Williams GR, Dunne RF, Giri S, et al. Sarcopenia in the older adult with cancer. J Clin Oncol. 2021;39(19):2068-78. DOI: https://doi.org/10.1200/JCO.21.00102

Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet. 2019;393(10191):2636-46. doi: https://doi.org/10.1016/S0140-6736(19)31138-9 DOI: https://doi.org/10.1016/S0140-6736(19)31138-9

Papadopoulou SK. Sarcopenia: a contemporary health problem among older adult populations. Nutrients. 2020;12(5):1293. DOI: https://doi.org/10.3390/nu12051293

Papadopoulou SK, Tsintavis P, Potsaki G, et al. Differences in the prevalence of sarcopenia in community-dwelling, nursing home and hospitalized individuals. a systematic review and meta-analysis. J Nutr Health Aging. 2019;24:83-90. doi: https://doi.org/10.1007/s12603-019-1267-x DOI: https://doi.org/10.1007/s12603-019-1267-x

Queiroz MSC, Wiegert EVM, Lima LC, et al. Associação entre sarcopenia, estado nutricional e qualidade de vida em pacientes com câncer avançado em cuidados paliativos. Rev Bras Cancerol. 2018;64(1):69-75. doi: https://doi.org/10.32635/2176-9745.RBC.2018v64n1.120 DOI: https://doi.org/10.32635/2176-9745.RBC.2018v64n1.120

Catikkas NM, Bahat Z, Oren MM, et al. Older cancer patients receiving radiotherapy: a systematic review for the role of sarcopenia in treatment outcomes. Aging Clin Exp Res. 2022;34(8):1747-59. doi: https://doi.org/10.1007/s40520-022-02085-0 DOI: https://doi.org/10.1007/s40520-022-02085-0

Barbosa-Silva TG, Bielemann RM, Gonzalez MC, et al. Prevalence of sarcopenia among community-dwelling elderly of a medium-sized South American city: results of the COMO VAI? study. J Cachexia Sarcopenia Muscle. 2016;7(2):136-43. doi: https://doi.org/10.1002/jcsm.12049 DOI: https://doi.org/10.1002/jcsm.12049

Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-2. doi: https://doi.org/10.1016/j.jamda.2013.05.018 DOI: https://doi.org/10.1016/j.jamda.2013.05.018

Gonçalves TJM, Horie LM, Gonçalves SEAB, et al. Diretriz Braspen de terapia nutricional no envelhecimento. Braspen [Internet]. 2019[acesso 2023 nov 8];34(supl3):1-68 Disponível em: https://www.braspen.org/_files/ugd/a8daef_13e9ef81b44e4f66be32ec79c4b0fbab.pdf

Santos LS. Precisão e aplicabilidade do questionário SARC-F e SARC-CALF na triagem de sarcopenia em pacientes idosos hospitalizados [manuscrito na Internet]. Recife: Universidade Federal de Pernambuco; 2022. [acesso 2023 nov 20]. Disponível em: https://repositorio.ufpe.br/handle/123456789/44578

Organización Panamericana de la Salud. División de Promoción y Protección de la Salud. Encuesta Multicentrica salud beinestar y envejecimiento (SABE) em América Latina el Caribe: Informe Preliminar. In: 26º Reunión del Comité asesor de investigaciones em Salud [Internet]; 2001 jun 9-11; Kingston (Jamaica): OPAS; 2002. [acesso 2023 nov 20]. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/lil-381614

Gonzalez MC, Mehrnezhad A, Razaviarab N, et al. Calf circumference: cutoff values from the NHANES 1999–2006. Am J Clin Nutr. 2021;113(6):1679-87. doi: https://doi.org/10.1093/ajcn/nqab029 DOI: https://doi.org/10.1093/ajcn/nqab029

Frisancho AR. Anthropometric Standards for the Assessment of growth and nutritional status. Ann Arbor: University of Michigan Library; 1990. doi: https://doi.org/10.3998/mpub.12198 DOI: https://doi.org/10.3998/mpub.12198

Blackburn GL, Thornton PA. Nutritional assessment of the hospitalized patient. Med Clin North Am [Internet]. 1979[acesso 2023 nov 3];63(5):11103-15. Disponível em: https://pubmed.ncbi.nlm.nih.gov/116095/ DOI: https://doi.org/10.1016/S0025-7125(16)31663-7

Blackburn GL, Bistrian BR, Schlamm HT, et al. Nutritional and metabolic assessment of the hospitalized patient. J Parenter Enteral Nutr. 1977;1(1):11-21. DOI: https://doi.org/10.1177/014860717700100101

Vellas B, Villars H, Abellan G, et al. Overview of the MNA--Its history and challenges. J Nutr Health Aging [Internet]. 2006 [acesso 2023 nov 3];10(6):456-63. Disponível em: https://pubmed.ncbi.nlm.nih.gov/17183418/

Shechtman O, Gestewitz L, Kimble C. Reliability and validity of the dynex dynamometer. J Hand Therap. 2005;18(3):339-47. doi: https://doi.org/10.1197/j.jht.2005.04.002 DOI: https://doi.org/10.1197/j.jht.2005.04.002

Bielemann RM, Gigante DP, Horta BL. Birth weight, intrauterine growth restriction and nutritional status in childhood in relation to grip strength in adults: from the 1982 Pelotas (Brazil) birth cohort. Nutrition. 2016;32(2):228-35. DOI: https://doi.org/10.1016/j.nut.2015.08.014

SPSS®: Statistical Package for Social Science (SPSS) [Internet]. Versão 20.0. [Nova York]. International Business Machines Corporation. [acesso 2023 mar 9]. Disponível em: https://www.ibm.com/br-pt/spss?utm_content=SRCWW&p1=Search&p4=43700077515785492&p5=p&gclid=CjwKCAjwgZCoBhBnEiwAz35Rwiltb7s14pOSLocnooMOQh9qAL59IVc9WP4ixhNTVMjenRp3-aEgxoCubsQAvD_BwE&gclsrc=aw.ds

Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção I:59.

Beukers K, Voorn MJJ, Trepels R, et al. Associations between outcome variables of nutritional screening methods and systemic treatment tolerance in patients with colorectal cancer: a systematic review. J Geriatr Oncol [Internet]. 2022 [acesso 2023 abr 18];13(8):1092-102. Disponível em: https://doi.org/10.1016/j.jgo.2022.06.010 DOI: https://doi.org/10.1016/j.jgo.2022.06.010

Celik E, Suzan V, Samanci NS, et al. Sarcopenia assessment by new EWGSOP2 criteria for predicting chemotherapy dose-limiting toxicity in patients with gastrointestinal tract tumors. Eur Geriatr Med. 2022;13(1):267-74. doi: https://doi.org/10.1007/s41999-021-00592-3 DOI: https://doi.org/10.1007/s41999-021-00592-3

Bozzetti F. Chemotherapy-Induced sarcopenia. Curr Treat Options Oncol. 2020;21(1):7. doi: https://doi.org/10.1007/s11864-019-0691-9 DOI: https://doi.org/10.1007/s11864-019-0691-9

Mori N, Maeda K, Fukami Y, et al. High SARC-F score predicts poor survival of patients with cancer receiving palliative care. Support Care Cancer. 2022;30:4065-72. doi: https://doi.org/10.1007/s00520-022-06845-6 DOI: https://doi.org/10.1007/s00520-022-06845-6

Nascimento MK, Costa Pereira JPD, Araújo JO, et al. Exploring the role of body mass index-adjusted calf circumference within the SARC-CalF screening tool among older patients with cancer. J Nutr Health Aging. 2024;28(7):100251. doi: https://doi.org/10.1016/j.jnha.2024.100251 DOI: https://doi.org/10.1016/j.jnha.2024.100251

Fonseca J, Machado FVC, Santin LC, et al. Handgrip strength as a reflection of general muscle strength in chronic obstructive pulmonary disease. COPD (Online). 2021;18(3):299-306. DOI: https://doi.org/10.1080/15412555.2021.1919608

Malmstrom TK, Miller DK, Simonsick EM, et al. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle. 2016;7(1):28-36. DOI: https://doi.org/10.1002/jcsm.12048

Sousa IM, Burgel CF, Silva FM, et al. Prognostic value of isolated sarcopenia or malnutrition–sarcopenia syndrome for clinical outcomes in hospitalized patients. Nutrients. 2022;14(11):2207. doi: https://doi.org/10.3390/nu14112207 DOI: https://doi.org/10.3390/nu14112207

Martin L, Gioulbasanis I, Senesse P, et al. Cancer‐Associated malnutrition and CT‐defined sarcopenia and myosteatosis are endemic in overweight and obese patients. J. parenter. enteral nutr. 2019;44(2):227-38. DOI: https://doi.org/10.1002/jpen.1597

Ligthart-Melis GC, Luiking YC, Kakourou A, et al. Frailty, sarcopenia, and malnutrition frequently (co-)occur in hospitalized older adults: a systematic review and meta-analysis. J Am Med Dir Assoc. 2020: 21(9):1216-28. DOI: https://doi.org/10.1016/j.jamda.2020.03.006

Kiss N, Prado CM, Daly RM, et al. Low muscle mass, malnutrition, sarcopenia, and associations with survival in adults with cancer in the UK Biobank cohort. J Cachexia Sarcopenia Muscle. 2023;14(4):1775-1788 doi: https://doi.org/10.1002/jcsm.13256 DOI: https://doi.org/10.1002/jcsm.13256

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Published

2024-05-14

How to Cite

1.
Silva HKM, Cavalcante L de S, Almeida GAS, Pereira JP da C, Luz MCL. Risk of Sarcopenia and Gastrointestinal Toxicity of Older Patients Undergoing Chemotherapy. Rev. Bras. Cancerol. [Internet]. 2024 May 14 [cited 2024 Dec. 26];70(2):e-054606. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/4606

Issue

Vol. 70 No. 2 (2024): Apr./May/June

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ORIGINAL ARTICLE

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