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Background: Studies examining changes in skeletal muscle and adipose tissue during treatment for cancer in children, adolescents, and young adults and their effect on the risk of chemotherapy toxicity (chemotoxicity) are limited. Methods: Among 78 patients with lymphoma (79.5%) and rhabdomyosarcoma (20.5%), changes were measured in skeletal muscle (skeletal muscle index [SMI]; skeletal muscle density [SMD]) and adipose tissue (height‐adjusted total adipose tissue [hTAT]) between baseline and first subsequent computed tomography scans at the third lumbar vertebral level by using commercially available software. Body mass index (BMI; operationalized as a percentile [BMI%ile]) and body surface area (BSA) were examined at each time point. The association of changes in body composition with chemotoxicities was examined by using linear regression. Results: The median age at cancer diagnosis of this cohort (62.8% male; 55.1% non‐Hispanic White) was 12.7 years (2.5–21.1 years). The median time between scans was 48 days (range, 8–207 days). By adjusting for demographics and disease characteristics, this study found that patients undergo a significant decline in SMD (β ± standard error [SE] = −4.1 ± 1.4; p <.01). No significant changes in SMI (β ± SE = −0.5 ± 1.0; p =.7), hTAT (β ± SE = 5.5 ± 3.9; p =.2), BMI% (β ± SE = 4.1 ± 4.8; p =.3), or BSA (β ± SE = −0.02 ± 0.01; p =.3) were observed. Decline in SMD (per Hounsfield unit) was associated with a greater proportion of chemotherapy cycles with grade ≥3 nonhematologic toxicity (β ± SE = 1.09 ± 0.51; p =.04). Conclusions: This study shows that children, adolescents, and young adults with lymphoma and rhabdomyosarcoma undergo a decline in SMD early during treatment, which is associated with a risk of chemotoxicities. Future studies should focus on interventions designed at preventing the loss of muscle during treatment. Plain Language Summary: We show that among children, adolescents, and young adults with lymphoma and rhabdomyosarcoma receiving chemotherapy, skeletal muscle density declines early during treatment.Additionally, a decline in skeletal muscle density is associated with a greater risk of nonhematologic chemotoxicities. Skeletal muscle density declines significantly in the first few weeks of treatment in children, adolescents, and young adults with lymphoma and rhabdomyosarcoma. Decline in skeletal muscle density is associated with a greater risk of nonhematologic toxicities. [ABSTRACT FROM AUTHOR]

Purpose: To validate the association between body composition and mortality in men treated with radiation for localized prostate cancer (PCa). Secondarily, to integrate body composition as a factor to classify patients by risk of all‐cause mortality. Materials and Methods: Participants of NRG/Radiation Therapy Oncology Group (RTOG) 9406 and NRG/RTOG 0126 with archived computed tomography were included. Muscle mass and muscle density were estimated by measuring the area and attenuation of the psoas muscles on a single slice at L4–L5. Bone density was estimated by measuring the attenuation of the vertebral body at mid‐L5. Survival analyses, including Cox proportional hazards models, assessed the relationship between body composition and mortality. Recursive partitioning analysis (RPA) was used to create a classification tree to classify participants by risk of death. Results: Data from 2066 men were included in this study. In the final multivariable model, psoas area, comorbidity score, baseline prostate serum antigen, and age were significantly associated with survival. The RPA yielded a classification tree with four prognostic groups determined by age, comorbidity, and psoas area. Notably, the classification among older (≥70 years) men into prognostic groups was determined by psoas area. Conclusions: This study strongly supports that body composition is related to mortality in men with localized PCa. The inclusion of psoas area in the RPA classification tree suggests that body composition provides additive information to age and comorbidity status for mortality prediction, particularly among older men. More research is needed to determine the clinical impact of body composition on prognostic models in men with PCa. This study strongly supports that body composition is related to mortality in men with localized prostate cancer. The inclusion of psoas area in the recursive partitioning analysis classification tree suggests that body composition provides additive information to age and comorbidity status for mortality prediction, particularly among older men. [ABSTRACT FROM AUTHOR]

Background: Body composition is associated with chemotherapy toxicity (chemotoxicity) in adults with cancer; this association remains unexplored in children with cancer. Methods: Using baseline computed tomography scans of 107 children with Hodgkin lymphoma (n = 45), non‐Hodgkin lymphoma (n = 42), or rhabdomyosarcoma (n = 20), this study examined body composition (skeletal muscle index [SMI], skeletal muscle density [SMD], and height‐adjusted total adipose tissue [hTAT]) to determine its association with chemotoxicity. Clinical characteristics and chemotoxicities were abstracted from medical records. Primary outcomes included grade 4 or higher hematologic toxicities and grade 3 or higher nonhematologic toxicities within 6 months of the diagnosis. Logistic regression models accounting for repeated measures were constructed to examine the association between body composition indices and chemotoxicities; adjustments were made for age at diagnosis, sex, race/ethnicity, cancer type, risk group, body mass index (measured as a percentile), or body surface area. Results: The median SMI was 41.0 cm2/m2 (range, 25.8‐68.6 cm2/m2), the median SMD was 54.1 HU (range, 35‐69.4 HU), and the median hTAT was 19.5 cm2/m2 (range, 0‐226.7 cm2/m2). Grade 4 or higher hematologic toxicities and grade 3 or higher nonhematologic toxicities were observed in 74.7% and 66.3% of the chemotherapy cycles, respectively. A higher SMD at diagnosis was associated with lower odds of grade 4 or higher hematologic toxicity (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.85‐0.97; P =.004). SMI (OR, 0.99; 95% CI, 0.95‐1.04; P =.7) and hTAT (OR, 1.00; 95% CI, 0.99‐1.01; P =.9) were not associated with hematologic toxicities. Nonhematologic toxicities did not show any association with body composition. Conclusions: The association between low SMD and hematologic toxicities in children with lymphoma or rhabdomyosarcoma could be due to body composition–based biodistribution of chemotherapeutic agents and needs further investigation. Lay Summary: Body composition at cancer diagnosis in children with lymphoma and rhabdomyosarcoma may provide information that could identify those at risk for serious side effects from chemotherapy.Routinely used measures such as body mass index and body surface area show poor correlations with body composition assessed via computed tomography scans. The body mass index or body surface area of children at cancer diagnosis shows a poor to modest correlation with body composition assessed via computed tomography (CT) scans. A low skeletal muscle density as measured by CT scans at cancer diagnosis may identify children at risk for serious hematologic toxicities. [ABSTRACT FROM AUTHOR]