Muscle mass dynamics during radiochemotherapy for head and neck carcinoma ; Dynamique de la masse musculaire en cours de radiochimiothérapie pour un carcinome des voies aérodigestives supérieures

Introduction: Sarcopenia is a negative prognostic factor in head and neck cancer. The value of the cross-sectional area of paravertebral and sternocleidomastoid muscles, measured on a single CT slice at C3 vertebra level, has been proposed to assess skeletal muscle mass and detect sarcopenia. To date, few prospective studies have described the evolution of muscle mass during radiochemotherapy. The main objective of this study is to describe the change in C3 muscle area during treatment. Material and methods: The study population consists of 30 consecutive patients treated with radiochemotherapy at the Grenoble-Alpes University Hospital (France), for head and neck carcinoma. This is a prospective cohort study with inclusions from October 2020 to June 2021. Paravertebral and sternocleidomastoid muscles were delineated on Mega Voltage CT (MVCT) images performed for daily repositioning of radiation therapy treatment. This enables the assessment of the variation of cervical muscle mass over time. Univariate analyses (Fisher’s exact test and Mann Whitney test) identify risk factors of skeletal muscle mass decline. Results: The mean weight change was -6.7% (SD = 4.3%) between the start and end of radiotherapy. The mean change in muscle area in C3 was -5.5% (SD = 8.5%) with significant heterogeneity. In univariate analysis, patients without enteral nutrition had the greatest loss of muscle mass (p = 0.04). Conclusion: This study confirms that loss of muscle mass is an early effect of radiochemotherapy for head and neck carcinoma. It affects about two thirds of patients. Although small in number, our data suggest that enteral nutrition may decrease this risk. ; Introduction. La sarcopénie est un facteur pronostique péjoratif en cancérologie des voies aérodigestives supérieures. La mesure de la surface des muscles paravertébraux et sternocléidomastoïdien sur une coupe unique en C3 a été proposée pour estimer la masse musculaire et repérer les patients sarcopéniques. Jusqu’à présent, peu d’études prospectives ont décrit ...