Assessment of Nutritional Status in Cancer – The Relationship Between Body Composition and Pharmacokinetics
Carla M. M. Prado,
Yara L. M. Maia,
Michael B. Sawyer,
Vickie E. Baracos.
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.
Keywords: Body composition, cancer, cancer prognosis, chemotherapy treatment, nutritional assessment, nutritional status, pharmacokinetics.
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