Should calculation of chemotherapy dosage for bowel cancer be based on body composition?

Should calculation of chemotherapy dosage for bowel cancer be based on body composition?
Tidsskr Nor Laegeforen. 2020 May 26;140(8):
Authors: Kværner AS, Harnæs H, Alavi DH, Bärebring L, Henriksen HB, Guren MG, Lauritzen PM, Eggesbø HB, Wiedswang G, Smeland S, Blomhoff R
Abstract
BACKGROUND: Dosage of chemotherapy for colon cancer is currently based on the patient's body surface area. Several studies have identified an association between low fat-free mass and chemotherapy toxicity among patients with metastatic colorectal cancer. This has been less widely studied for localised disease. This review aims to summarise studies that have investigated the association between clinical signs of disease-related malnutrition (low body mass index, weight loss and low muscle mass) and tolerance of chemotherapy in patients with localised colon cancer.
MATERIAL AND METHOD: We conducted a systematic search in PubMed with various synonyms of the terms 'colorectal cancer', 'adjuvant chemotherapy', 'nutritional status' and 'toxicity'. The search was concluded in May 2019. Of 553 articles, 39 were considered relevant and read in full text. Ten of these fulfilled the inclusion criteria for this review.
RESULTS: Nine of the ten studies indicate an association between clinical signs of disease-related malnutrition and dose-limiting toxicity. The association appears to be especially pronounced in patients with low fat-free mass.
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Source: Tidsskrift for den Norske Laegeforening - May 25, 2020 Category: General Medicine Authors: Kværner AS, Harnæs H, Alavi DH, Bärebring L, Henriksen HB, Guren MG, Lauritzen PM, Eggesbø HB, Wiedswang G, Smeland S, Blomhoff R Tags: Tidsskr Nor Laegeforen Source Type: research