Body composition in chemotherapy: the promising role of CT scans

Curr Opin Clin Nutr Metab Care. 2013 Sep;16(5):525-33. doi: 10.1097/MCO.0b013e328363bcfb.


Purpose of review: Reducing cancer-treatment toxicity was a largely ignored research agenda, which is now emerging as an active area of investigation. Studies of human body composition using computerized tomography scans have provided proof-of-concept that variability in drug disposition and toxicity profiles may be partially explained by different features in body composition.

Recent findings: Collectively, studies suggest that skeletal muscle depletion (regardless of body weight) is an independent predictor of severe toxicity, affecting cancer treatment and its outcomes. Although precise mechanisms are unknown, pharmacokinetic parameters such as variations in volume of distribution and increased drug exposure may explain such findings.

Summary: Computerized tomography scans are readily available in clinical databases of diagnostic images and provide feasible, reliable, and highly differentiated measurements of body composition. These images should be used to optimize screening and management of patients in order to prevent severe toxicity, and to improve the efficacy and cost-efficiency of chemotherapy treatments.

Publication types

  • Review

MeSH terms

  • Anthracyclines / administration & dosage
  • Anthracyclines / adverse effects
  • Body Composition / physiology*
  • Body Weight
  • Chemotherapy, Adjuvant / adverse effects
  • Drug Therapy / methods*
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Humans
  • Indoles / administration & dosage
  • Indoles / adverse effects
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / pathology
  • Neoplasms / drug therapy
  • Niacinamide / administration & dosage
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds / administration & dosage
  • Phenylurea Compounds / adverse effects
  • Pyrimidines / administration & dosage
  • Pyrimidines / adverse effects
  • Pyrroles / administration & dosage
  • Pyrroles / adverse effects
  • Reproducibility of Results
  • Sorafenib
  • Sunitinib
  • Tomography, X-Ray Computed*


  • Anthracyclines
  • Indoles
  • Phenylurea Compounds
  • Pyrimidines
  • Pyrroles
  • Niacinamide
  • 5-fluoropyrimidine
  • Sorafenib
  • Sunitinib