Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients
Cachexia and sarcopenia are associated with poor outcome and increased chemotherapy-induced toxicity in lung cancer patients. However, the complex interplay of obesity, sarcopenia and cachexia, and its impact on survival in the context of first-line-chemotherapy is not yet understood. In 200 consecu...
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| creator | Nattenmüller, Johanna Wochner, Raoul Muley, Thomas Steins, Martin Hummler, Simone Teucher, Birgit Wiskemann, Joachim Kauczor, Hans-Ulrich Wielpütz, Mark Oliver Heussel, Claus Peter |
| description | Cachexia and sarcopenia are associated with poor outcome and increased chemotherapy-induced toxicity in lung cancer patients. However, the complex interplay of obesity, sarcopenia and cachexia, and its impact on survival in the context of first-line-chemotherapy is not yet understood.
In 200 consecutively recruited lung cancer patients (70 female, mean age 62y; mean BMI 25 kg/m2; median follow-up 15.97 months) with routine staging-CT before and after chemotherapy (CTX, mean interval: 4.3 months), densitometric quantification of total (TFA), visceral (VFA), and subcutaneous-fat-area (SFA), inter-muscular-fat-area (IMFA), muscle-density (MD), muscle-area (MA) and skeletal-muscle-index (SMI) was performed retrospectively to evaluate changes under chemotherapy and the impact on survival.
We observed increases in TFA, VFA, SFA, VFA/SFA, and IMFA (p |
| doi_str_mv | 10.1371/journal.pone.0169136 |
| format | Article |
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In 200 consecutively recruited lung cancer patients (70 female, mean age 62y; mean BMI 25 kg/m2; median follow-up 15.97 months) with routine staging-CT before and after chemotherapy (CTX, mean interval: 4.3 months), densitometric quantification of total (TFA), visceral (VFA), and subcutaneous-fat-area (SFA), inter-muscular-fat-area (IMFA), muscle-density (MD), muscle-area (MA) and skeletal-muscle-index (SMI) was performed retrospectively to evaluate changes under chemotherapy and the impact on survival.
We observed increases in TFA, VFA, SFA, VFA/SFA, and IMFA (p<0.05-0.001), while there were decreases in MA, MD and BMI (p<0.05-0.001) after chemotherapy. High pre-therapeutic VFA/SFA was a predictive factor for poor survival (HR = 1.272; p = 0.008), high pre-therapeutic MD for improved survival (HR = 0.93; p<0.05). Decrease in BMI (HR = 1.303; p<0.001), weight (HR = 1.067; p<0.001) and SMI (HR = 1.063; p<0.001) after chemotherapy were associated with poor survival. Patients with ≥4 CTX-cycles showed increased survival (17.6 vs. 9.1months), less muscle depletion (SMIdifference: p<0.05) and no BMI loss (BMIdifference: p<0.001).
After chemotherapy, patients exhibited sarcopenia with decreased muscle and increased adipose tissue compartments, which was not adequately mirrored by BMI and weight loss but by imaging. Particularly sarcopenic patients received less CTX-cycles and had poorer survival. As loss of BMI, weight and muscle were associated with poor survival, early detection (via imaging) and prevention (via physical exercise and nutrition) of sarcopenia may potentially improve outcome and reduce chemotherapy-induced toxicity.]]></description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0169136</identifier><identifier>PMID: 28107410</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adipose tissue ; Adipose Tissue - diagnostic imaging ; Adipose Tissue - pathology ; Aged ; Antineoplastic Agents - therapeutic use ; Biology and Life Sciences ; Body Composition ; Body mass ; Body weight loss ; Breast cancer ; Cachexia ; Cancer ; Cancer therapies ; Care and treatment ; Chemotherapy ; Colorectal cancer ; Compartments ; Computed tomography ; Densitometers ; Female ; Health aspects ; Hospitals ; Humans ; Lung cancer ; Lung diseases ; Lung Neoplasms - diagnostic imaging ; Lung Neoplasms - drug therapy ; Lung Neoplasms - pathology ; Male ; Medical prognosis ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Muscle, Skeletal - diagnostic imaging ; Muscle, Skeletal - pathology ; Muscles ; Musculoskeletal system ; Nuclear medicine ; Nutrition ; Obesity ; Oncology ; Patients ; Physical exercise ; Prognosis ; Retrospective Studies ; Sarcopenia ; Skeletal muscle ; Survival ; Survival Analysis ; Toxicity ; Tumors ; Weight control</subject><ispartof>PloS one, 2017-01, Vol.12 (1), p.e0169136</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Nattenmüller et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Nattenmüller et al 2017 Nattenmüller et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c791t-86ff640dd4f7a18e272d5da287839d27d9585ac337701ce3d5489ccd19bbd44a3</citedby><cites>FETCH-LOGICAL-c791t-86ff640dd4f7a18e272d5da287839d27d9585ac337701ce3d5489ccd19bbd44a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5249228/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5249228/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28107410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Singh, Pankaj K</contributor><creatorcontrib>Nattenmüller, Johanna</creatorcontrib><creatorcontrib>Wochner, Raoul</creatorcontrib><creatorcontrib>Muley, Thomas</creatorcontrib><creatorcontrib>Steins, Martin</creatorcontrib><creatorcontrib>Hummler, Simone</creatorcontrib><creatorcontrib>Teucher, Birgit</creatorcontrib><creatorcontrib>Wiskemann, Joachim</creatorcontrib><creatorcontrib>Kauczor, Hans-Ulrich</creatorcontrib><creatorcontrib>Wielpütz, Mark Oliver</creatorcontrib><creatorcontrib>Heussel, Claus Peter</creatorcontrib><title>Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description><![CDATA[Cachexia and sarcopenia are associated with poor outcome and increased chemotherapy-induced toxicity in lung cancer patients. However, the complex interplay of obesity, sarcopenia and cachexia, and its impact on survival in the context of first-line-chemotherapy is not yet understood.
In 200 consecutively recruited lung cancer patients (70 female, mean age 62y; mean BMI 25 kg/m2; median follow-up 15.97 months) with routine staging-CT before and after chemotherapy (CTX, mean interval: 4.3 months), densitometric quantification of total (TFA), visceral (VFA), and subcutaneous-fat-area (SFA), inter-muscular-fat-area (IMFA), muscle-density (MD), muscle-area (MA) and skeletal-muscle-index (SMI) was performed retrospectively to evaluate changes under chemotherapy and the impact on survival.
We observed increases in TFA, VFA, SFA, VFA/SFA, and IMFA (p<0.05-0.001), while there were decreases in MA, MD and BMI (p<0.05-0.001) after chemotherapy. High pre-therapeutic VFA/SFA was a predictive factor for poor survival (HR = 1.272; p = 0.008), high pre-therapeutic MD for improved survival (HR = 0.93; p<0.05). Decrease in BMI (HR = 1.303; p<0.001), weight (HR = 1.067; p<0.001) and SMI (HR = 1.063; p<0.001) after chemotherapy were associated with poor survival. Patients with ≥4 CTX-cycles showed increased survival (17.6 vs. 9.1months), less muscle depletion (SMIdifference: p<0.05) and no BMI loss (BMIdifference: p<0.001).
After chemotherapy, patients exhibited sarcopenia with decreased muscle and increased adipose tissue compartments, which was not adequately mirrored by BMI and weight loss but by imaging. Particularly sarcopenic patients received less CTX-cycles and had poorer survival. As loss of BMI, weight and muscle were associated with poor survival, early detection (via imaging) and prevention (via physical exercise and nutrition) of sarcopenia may potentially improve outcome and reduce chemotherapy-induced toxicity.]]></description><subject>Adipose tissue</subject><subject>Adipose Tissue - diagnostic imaging</subject><subject>Adipose Tissue - pathology</subject><subject>Aged</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Biology and Life Sciences</subject><subject>Body Composition</subject><subject>Body mass</subject><subject>Body weight loss</subject><subject>Breast cancer</subject><subject>Cachexia</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Compartments</subject><subject>Computed tomography</subject><subject>Densitometers</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Lung Neoplasms - diagnostic imaging</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - pathology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Muscle, Skeletal - diagnostic imaging</subject><subject>Muscle, Skeletal - pathology</subject><subject>Muscles</subject><subject>Musculoskeletal system</subject><subject>Nuclear medicine</subject><subject>Nutrition</subject><subject>Obesity</subject><subject>Oncology</subject><subject>Patients</subject><subject>Physical exercise</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sarcopenia</subject><subject>Skeletal muscle</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Toxicity</subject><subject>Tumors</subject><subject>Weight control</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12LEzEUhgdR3LX6D0QHBNGLqfmaTOZmYalWC5VddfU2ZPLRZpkmNcmIe-VfN_3YpZW9kBASkue8yXmTUxTPIRhD3MB3134ITvTjtXd6DCBtIaYPilPYYlRRBPDDg_lJ8STGawBqzCh9XJwgBkFDIDgt_lwGv3A-JivL2WotZCq9KSdX1ZdBuGSN1ar8PETZ61I4VU5FKt_bmILthmS9KzttfNjtCZN0KKc2xFTNrdPVZKlXPi11EOub0rpyPrhFORFOZuxSJKtdik-LR0b0UT_bj6Pi-_TD1eRTNb_4OJuczyvZtDBVjBpDCVCKmEZAplGDVK0EYg3DrUKNamtWC4lx0wAoNVY1Ya2UCrZdpwgReFS83Omuex_53rvIIaMAtTVlMBOzHaG8uObrYFci3HAvLN8u-LDgImSbes1Z19UdIJ1BjBJGu860rUEUa0UJprmPirP9aUO30krmTIPoj0SPd5xd8oX_xWtEWoRYFnizFwj-56Bj4isbpe574bQftvdmmEAK64y--ge9P7s9tRA5AeuMz-fKjSg_Jw3LRgK2uff4Hio3pVdW5o9mbF4_Cnh7FJCZpH-nhRhi5LNvX_-fvfhxzL4-YJda9GkZfb_9c_EYJDtQBh9j0ObOZAj4pk5u3eCbOuH7OslhLw4f6C7otjDwXzFmDZg</recordid><startdate>20170120</startdate><enddate>20170120</enddate><creator>Nattenmüller, Johanna</creator><creator>Wochner, Raoul</creator><creator>Muley, Thomas</creator><creator>Steins, Martin</creator><creator>Hummler, Simone</creator><creator>Teucher, Birgit</creator><creator>Wiskemann, Joachim</creator><creator>Kauczor, Hans-Ulrich</creator><creator>Wielpütz, Mark Oliver</creator><creator>Heussel, Claus Peter</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170120</creationdate><title>Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients</title><author>Nattenmüller, Johanna ; Wochner, Raoul ; Muley, Thomas ; Steins, Martin ; Hummler, Simone ; Teucher, Birgit ; Wiskemann, Joachim ; Kauczor, Hans-Ulrich ; Wielpütz, Mark Oliver ; Heussel, Claus Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c791t-86ff640dd4f7a18e272d5da287839d27d9585ac337701ce3d5489ccd19bbd44a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adipose tissue</topic><topic>Adipose Tissue - diagnostic imaging</topic><topic>Adipose Tissue - pathology</topic><topic>Aged</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Biology and Life Sciences</topic><topic>Body Composition</topic><topic>Body mass</topic><topic>Body weight loss</topic><topic>Breast cancer</topic><topic>Cachexia</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Compartments</topic><topic>Computed tomography</topic><topic>Densitometers</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>Lung diseases</topic><topic>Lung Neoplasms - diagnostic imaging</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - pathology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Muscle, Skeletal - diagnostic imaging</topic><topic>Muscle, Skeletal - pathology</topic><topic>Muscles</topic><topic>Musculoskeletal system</topic><topic>Nuclear medicine</topic><topic>Nutrition</topic><topic>Obesity</topic><topic>Oncology</topic><topic>Patients</topic><topic>Physical exercise</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Sarcopenia</topic><topic>Skeletal muscle</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Toxicity</topic><topic>Tumors</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nattenmüller, Johanna</creatorcontrib><creatorcontrib>Wochner, Raoul</creatorcontrib><creatorcontrib>Muley, Thomas</creatorcontrib><creatorcontrib>Steins, Martin</creatorcontrib><creatorcontrib>Hummler, Simone</creatorcontrib><creatorcontrib>Teucher, Birgit</creatorcontrib><creatorcontrib>Wiskemann, Joachim</creatorcontrib><creatorcontrib>Kauczor, Hans-Ulrich</creatorcontrib><creatorcontrib>Wielpütz, Mark Oliver</creatorcontrib><creatorcontrib>Heussel, Claus Peter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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However, the complex interplay of obesity, sarcopenia and cachexia, and its impact on survival in the context of first-line-chemotherapy is not yet understood.
In 200 consecutively recruited lung cancer patients (70 female, mean age 62y; mean BMI 25 kg/m2; median follow-up 15.97 months) with routine staging-CT before and after chemotherapy (CTX, mean interval: 4.3 months), densitometric quantification of total (TFA), visceral (VFA), and subcutaneous-fat-area (SFA), inter-muscular-fat-area (IMFA), muscle-density (MD), muscle-area (MA) and skeletal-muscle-index (SMI) was performed retrospectively to evaluate changes under chemotherapy and the impact on survival.
We observed increases in TFA, VFA, SFA, VFA/SFA, and IMFA (p<0.05-0.001), while there were decreases in MA, MD and BMI (p<0.05-0.001) after chemotherapy. High pre-therapeutic VFA/SFA was a predictive factor for poor survival (HR = 1.272; p = 0.008), high pre-therapeutic MD for improved survival (HR = 0.93; p<0.05). Decrease in BMI (HR = 1.303; p<0.001), weight (HR = 1.067; p<0.001) and SMI (HR = 1.063; p<0.001) after chemotherapy were associated with poor survival. Patients with ≥4 CTX-cycles showed increased survival (17.6 vs. 9.1months), less muscle depletion (SMIdifference: p<0.05) and no BMI loss (BMIdifference: p<0.001).
After chemotherapy, patients exhibited sarcopenia with decreased muscle and increased adipose tissue compartments, which was not adequately mirrored by BMI and weight loss but by imaging. Particularly sarcopenic patients received less CTX-cycles and had poorer survival. As loss of BMI, weight and muscle were associated with poor survival, early detection (via imaging) and prevention (via physical exercise and nutrition) of sarcopenia may potentially improve outcome and reduce chemotherapy-induced toxicity.]]></abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28107410</pmid><doi>10.1371/journal.pone.0169136</doi><tpages>e0169136</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2017-01, Vol.12 (1), p.e0169136 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1860295681 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adipose tissue Adipose Tissue - diagnostic imaging Adipose Tissue - pathology Aged Antineoplastic Agents - therapeutic use Biology and Life Sciences Body Composition Body mass Body weight loss Breast cancer Cachexia Cancer Cancer therapies Care and treatment Chemotherapy Colorectal cancer Compartments Computed tomography Densitometers Female Health aspects Hospitals Humans Lung cancer Lung diseases Lung Neoplasms - diagnostic imaging Lung Neoplasms - drug therapy Lung Neoplasms - pathology Male Medical prognosis Medicine and Health Sciences Middle Aged Mortality Muscle, Skeletal - diagnostic imaging Muscle, Skeletal - pathology Muscles Musculoskeletal system Nuclear medicine Nutrition Obesity Oncology Patients Physical exercise Prognosis Retrospective Studies Sarcopenia Skeletal muscle Survival Survival Analysis Toxicity Tumors Weight control |
| title | Prognostic Impact of CT-Quantified Muscle and Fat Distribution before and after First-Line-Chemotherapy in Lung Cancer Patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T07%3A54%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prognostic%20Impact%20of%20CT-Quantified%20Muscle%20and%20Fat%20Distribution%20before%20and%20after%20First-Line-Chemotherapy%20in%20Lung%20Cancer%20Patients&rft.jtitle=PloS%20one&rft.au=Nattenm%C3%BCller,%20Johanna&rft.date=2017-01-20&rft.volume=12&rft.issue=1&rft.spage=e0169136&rft.pages=e0169136-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0169136&rft_dat=%3Cgale_plos_%3EA478287084%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1860295681&rft_id=info:pmid/28107410&rft_galeid=A478287084&rft_doaj_id=oai_doaj_org_article_8bb5b04bf286486bbf99f263ed643664&rfr_iscdi=true |