OBJECTIVE

To assess the relationship between skeletal muscle index (SMI) and the frequency, nature, and severity of toxic complications in patients with locally advanced and metastatic gastric cancer during antitumor drug therapy, a study is being conducted

MATERIAL AND METHODS

The study included 100 patients diagnosed with gastric cancer who had undergone four courses of chemotherapy. Computed tomography was used for sarcopenia diagnosis. SMI was calculated as the ratio of the average skeletal muscle area at the L3 level to the square of the patient’s height. The Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 scale was used to assess the severity of adverse events.

RESULTS

Correlation analysis showed a moderate, inverse, statistically significant relationship (p<0.05) between SMI before treatment and the severity of anemia and vomiting after the fourth course of chemotherapy (r=–0.302; r=–0.331). A moderate, inverse relationship (p<0.05) was observed between SMI and the severity of anemia, vomiting (r=–0.323; r=–0.397), and hypoproteinemia (r=–0.300) after four courses of chemotherapy. SMI before treatment correlated weakly (p<0.05) with the severity of leukopenia, hypoproteinemia, nausea, diarrhea after the fourth course of chemotherapy (r=–0.292; r=–0.276; r=–0.214; r=–0.283), showing an inverse relationship. The severity of thrombocytopenia, cytolytic syndrome, nausea, diarrhea, constipation, stomatitis after four courses of chemotherapy showed a very weak correlation (p>0.05) with SMI before treatment and after four courses of chemotherapy.

CONCLUSION

The presence of sarcopenia in patients with gastric cancer may serve as a predictor of an increase in the severity of toxicity of antitumor drug therapy. The routinely used bode mass index and body surface area during treatment are not reliable markers for predicting toxicity.