Toshiyuki Itai

Body composition as a predictive factor for chemotherapy-induced peripheral neuropathy and dose-limiting toxicity in patients with endometrial cancer undergoing carboplatin and paclitaxel

This study investigated whether lean body mass could predict the incidence of dose-limiting toxicity and chemotherapy-induced peripheral neuropathy in patients with endometrial cancer treated with carboplatin-paclitaxel. This retrospective study included patients with endometrial cancer who underwent carboplatin-paclitaxel after primary surgery. Lean body mass was calculated using an approximation formula based on abdominal computed tomography images. A multivariable analysis was conducted using a logistic regression model to explore the factors associated with the incidence of chemotherapy-induced peripheral neuropathy and dose-limiting toxicity, with age, body mass index, paclitaxel dose per lean body mass, and carboplatin dose per lean body mass as covariates. Subsequently, the cutoff value for the paclitaxel dose per lean body mass was determined based on the first quartile and receiver operating characteristic curve analysis, dividing the participants into high-dose and low-dose groups. Differences in the incidence of chemotherapy-induced peripheral neuropathy and dose-limiting toxicity between the 2 groups were examined. The study included 98 patients, with 35 (35.7%) and 31 (31.6%) experiencing chemotherapy-induced peripheral neuropathy and dose-limiting toxicity, respectively. The multivariable analysis showed that paclitaxel dose per lean body mass was significantly associated with the incidence of chemotherapy-induced peripheral neuropathy (OR 2.58, 95% CI 1.08 to 6.19) but was not significantly associated with the incidence of dose-limiting toxicity. The cutoff value for the paclitaxel dose per lean body mass was determined to be 8.12 mg/kg. The high-dose group showed a significantly higher incidence of chemotherapy-induced peripheral neuropathy (high-dose group, 52.0%; low-dose group 30.1%, p = .049) and a higher incidence of dose-limiting toxicity (high-dose group, 52.0%; low-dose group, 24.7%, p = .011) than the low-dose group. Paclitaxel dose per lean body mass may predict the incidence of chemotherapy-induced peripheral neuropathy in patients with endometrial cancer undergoing carboplatin-paclitaxel and could be suitable for dosage modulation of paclitaxel.