Abstract
Introduction
Osteosarcopenia is the progressive loss of musculoskeletal structure and functionality,
contributing to disability and mortality. Despite complex interactions between bone
and muscle, osteosarcopenia prevention and treatment in men with metastatic castration-resistant
prostate cancer (mCRPC) focuses predominantly on bone health. It is unknown whether
Radium-223 (Ra-223) therapy affects sarcopenia.
Methods
We identified 52 patients with mCRPC who had received Ra-223 and had a baseline plus
≥1 follow-up abdominopelvic CT scan. The total contour area (TCA) and averaged Hounsfield
units (HU) of the left and right psoas muscles were obtained at the inferior L3 endplate,
and the Psoas Muscle Index (PMI) was calculated therefrom. Intra-patient musculoskeletal
changes were analyzed across various time points.
Results
TCA and PMI gradually declined over the study period (p=0.002, p=0.003, respectively),
but Ra-223 therapy did not accelerate sarcopenia, nor the decline of HU compared to
the pre-Ra-223 period. The median overall survival of patients with baseline sarcopenia
was numerically worse (14.93 versus 23.23 months, HR 0.612, p=0.198).
Conclusions
Ra-223 does not accelerate sarcopenia. Thus, worsening muscle parameters in men with
mCRPC undergoing Ra-223 therapy are attributable to other factors. Further research
is needed to determine whether baseline sarcopenia predicts poor overall survival
in such patients.
Micro-Abstract
There are complex interactions between bone and skeletal muscle. However, the prevention
and treatment of treatment-induced osteosarcopenia in men with metastatic castration-resistant
prostate cancer focuses predominantly on bone health. In a single-center cohort of
52 patients we demonstrate that bone-targeted Radium-223 therapy does not accelerate
sarcopenia, but baseline sarcopenia is associated with poor survival in such patients.
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Article info
Publication history
Accepted:
January 21,
2023
Received in revised form:
January 19,
2023
Received:
June 24,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
