Gastrointestinal Cancer

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SU_12_2120 - Skeletal Muscle Depletion during Chemoradiotherapy and Radiomics Features As Prognostic Factors of Toxicity and Outcomes in Patients with Gastric Cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Skeletal Muscle Depletion during Chemoradiotherapy and Radiomics Features As Prognostic Factors of Toxicity and Outcomes in Patients with Gastric Cancer
W. Yang, F. Xia, J. Wang, R. Hu, M. Zhou, G. Li, Y. Yuan, and Z. Zhang; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China

Purpose/Objective(s): Skeletal muscle depletion (Sarcopenia) or ongoing muscle wasting have been reported in previous studies to be associated with higher chemotherapy-related toxicity and decreased survival. The aim of this study was to investigate whether changes in body composition during chemoradiotherapy, as well as radiomics features on CT scans can predict toxicity and outcomes in patients with advanced gastric cancer.

Materials/Methods: A total of 109 patients who received radical resection and chemoradiotherapy (CRT) between 2009 and 2015 with available CT scans obtained before and after chemoradiation were retrospectively examined. CT images at the level of the third lumber vertebral were analyzed using a commercially available deformable registration algorithm to assess cross-sectional areas and radiomics features for skeletal muscle. Comparisons between pre- and post-CRT images and its impact on toxicity and long-term outcomes were studied. Furthermore, 253 radiomics features were calculated using in-house radiomics software after segmentation. Concordance (c) statistics were used to test predictive accuracy of survival models.

Results: The skeletal muscle index decreased from 42.26cm2/m2 pre-CRT to 41.32cm2/m2 post-CRT (p=0.001). Relative muscle change during CRT was categorized into three groups: tertile one, <1.0%; tertile two, 1.0% to 3.8%; and tertile three, >3.8%. Skeletal muscle depletion was independently associated with overall survival (95% CI: 1.06 to 4.55; P=0.035). A cutoff value of muscle loss>10% seemed to be a threshold for dose-limiting toxicity of concurrent chemotherapy (P=0.047). Although no relationship was identified with disease-free survival in the clinical analysis, three radiomic features (GLRMS_RP, HL_GLRMS_LRE, and LH_absolute_std) was associated with disease-free survival and a prediction model containing radiomics features gave a c statistic of 0.73.

Conclusion: Loss of skeletal muscle mass during chemoradiotherapy is an independent prognostic factor for overall survival and radiomics features of skeletal muscle can predict disease-free survival for gastric cancer patients receiving adjuvant chemoradiation.

Author Disclosure: W. Yang: None. F. Xia: None. R. Hu: None. Z. Zhang: Independent Contractor; Varian Medical System.

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