title: Association of body composition with outcome of docetaxel chemotherapy in metastatic prostate cancer: a retrospective review.
abstract: BACKGROUND
  Docetaxel, a lipophilic drug, is indicated for castration-resistant metastatic prostate cancer. Most men with such disease would have had androgen-deprivation therapy, which decreases muscle and increases body fat. Obesity and body composition changes may influence the outcomes of docetaxel therapy.
  
  
  METHODS
  We conducted a retrospective review of 333 patients with metastatic prostate cancer treated with docetaxel at a comprehensive cancer center between October 7, 2004 and December 31, 2012. Body composition parameters were measured based on the areas of muscle and adipose tissues in the visceral and subcutaneous compartments on CT images at L3-4 levels. Dose calculations, toxicity and adverse reaction profiles, and overall survival were analyzed.
  
  
  RESULTS
  Obese patients were younger at the diagnosis of prostate cancer and had a shorter duration from diagnosis to docetaxel therapy. Analysis of body composition found that a high visceral fat-to-subcutaneous fat area ratio (VSR) was associated with poor prognosis but a high visceral fat-to-muscle area ratio (VMR) and high body mass index were associated with increased duration from starting docetaxel to death, allowing such men to catch up with patients with normal body mass index in overall survival from cancer diagnosis to death. Cox proportional hazard regression showed that age ≥65 years, high VSR, abnormal serum alkaline phosphatase, and >10% reduction of initial dosage were significant predictors of shorter time between starting docetaxel and death, and that high VMR, obesity, and weekly regimens were significant predictors of longer survival after docetaxel.
  
  
  CONCLUSIONS
  Obese and overweight patients may benefit more from weekly docetaxel regimens using the reference dosage of 35 mg/m2 without empirical dosage reduction.
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Weixin
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Xiandong
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Patrick
authors.initials: P
authors.lastname: Chaftari
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Cruz Carreras
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gonzalez
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Jayne
authors.initials: J
authors.lastname: Viets-Upchurch
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Kelly
authors.initials: K
authors.lastname: Merriman
authors.affiliation: Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Shi-Ming
authors.initials: SM
authors.lastname: Tu
authors.affiliation: Department of Symptoms Control and Supportive Care, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Shalini
authors.initials: S
authors.lastname: Dalal
authors.affiliation: Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America; Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
authors.forename: Sai-Ching J
authors.initials: SC
authors.lastname: Yeung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001823:Body Composition; D015992:Body Mass Index; D000077143:Docetaxel; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel
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