Psoas Muscle Volume Is a Predictive Marker of Fatigue and Anorexia in Prostate Cancer Patients Treated with Enzalutamide

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  • Kashiwagi Eiji
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Shiota Masaki
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Lee Ken
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Monji Keisuke
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Naganuma Hidekazu
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Matsumoto Takashi
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Takeuchi Ario
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Inokuchi Junichi
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
  • Eto Masatoshi
    Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

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<p>Introduction: Enzalutamide is approved for the treatment of patients with metastatic castration-resistant prostate cancer. Adverse effects (e.g., fatigue and anorexia) are often observed and cause difficulty with continuous therapy; however, no clinical data describing which patients are more likely to suffer adverse effects were observed. Therefore, this study hypothesized that body composition, comprising body fat distribution and psoas muscle volume, may affect the occurrence of subjective symptoms (e.g., fatigue and anorexia) in prostate cancer patients treated with enzalutamide.</p><p>Methods: Adverse effects, especially fatigue, anorexia, insomnia, and pain, were retrospectively evaluated by CTCAE v4.0 criteria. Sixty-seven prostate cancer patients treated with enzalutamide were enrolled, and body fat, visceral fat percentage, and psoas muscle ratio (psoas muscle, in cubic centimeter/height, in meters) were calculated using computed tomography images evaluated before enzalutamide, with SYNAPSE VINCENT software. Univariate analysis was performed to identify the factors associated with adverse effects.</p><p>Results: Univariate analysis showed that high psoas muscle ratio was significantly associated with fatigue (grade ≥ 2; odds ratio, 3.875; 95% confidence interval, 1.016-17.134; P = 0.047), but inversely related to anorexia (grade ≥ 2; odds ratio, 0.093; 95% confidence interval, 0.011-0.784; P = 0.029).</p><p>Conclusions: Psoas muscle ratio is a predictive marker of fatigue and anorexia in patients treated with enzalutamide.</p>

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  • JMA Journal

    JMA Journal 5 (4), 491-497, 2022-10-17

    公益社団法人 日本医師会 / 日本医学会

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