Body composition and chemotherapy toxicity among women treated for breast cancer: a systematic review

Heather Wopat; Tom Harrod; Rachel F Brem; Rebecca Kaltman; Kendall Anderson; Kim Robien

doi:10.1007/s11764-023-01380-7

Body composition and chemotherapy toxicity among women treated for breast cancer: a systematic review

J Cancer Surviv. 2023 Apr 24. doi: 10.1007/s11764-023-01380-7. Online ahead of print.

Authors

Heather Wopat¹, Tom Harrod², Rachel F Brem^{3

4}, Rebecca Kaltman⁵, Kendall Anderson⁴, Kim Robien^{6

7}

Affiliations

¹ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, NW, 2nd Floor, Washington, DC, 20052, USA.
² Himmelfarb Health Sciences Library, George Washington University, Washington, DC, USA.
³ Department of Radiology, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
⁴ GW Cancer Center, George Washington University, Washington, DC, USA.
⁵ Inova Schar Cancer Institute, Fairfax, VA, USA.
⁶ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, NW, 2nd Floor, Washington, DC, 20052, USA. krobien@gwu.edu.
⁷ GW Cancer Center, George Washington University, Washington, DC, USA. krobien@gwu.edu.

PMID: 37093518
DOI: 10.1007/s11764-023-01380-7

Abstract

Purpose: Toxicity is a significant problem among women receiving systemic chemotherapy for breast cancer, with up to 60% experiencing hematologic and 14% experiencing non-hematologic toxicity. Chemotherapy is dosed using body surface area, which does not account for heterogeneity in lean body mass (LBM) and adipose tissue (AT). This systematic review, registered with the PROSPERO International Prospective Register of Systematic Reviews (#CRD42021279874), evaluates associations between body composition and chemotherapy-related toxicity during breast cancer treatment.

Methods: Scientific literature databases (PubMed, Scopus, CINAHL, and CENTRAL) were systematically searched in November 2021 for studies evaluating associations between body composition (assessed using computed tomography or dual x-ray absorptiometry) and chemotherapy-related toxicity among women receiving breast cancer treatment. Eligibility was not limited by year or country of publication. Article screening and data abstraction was conducted using the Covidence Systematic Review Management System. Predetermined criteria were used to evaluate rigor of participant recruitment, representativeness of the population, and use of validated measures of body composition and toxicity.

Results: An inverse association between LBM and toxicity was reported in seven of the eight included studies, although definitions of low LBM differed across studies. Three studies evaluated the association between AT and chemotherapy toxicity with inconsistent findings. Heterogeneity in body composition measures/definitions and treatment regimens precluded the ability to perform meta-analyses.

Conclusion: Low LBM appears to be a risk factor for chemotherapy toxicity, but the role of AT is unclear.

Implications for cancer survivors: Further research that accounts for guideline concordance in chemotherapy prescriptions and the use of supportive care medications is needed.

Keywords: Body composition; Breast cancer; Chemotherapy; Toxicity.

Publication types

Review

Abstract

Publication types

Grants and funding