Preoperatieve chemoradiotherapie vermindert spiermassa en vetmassa bij rectumcarcinoompatiënten, vooral vrouwen

INTRODUCTION: Preoperative chemoradiotherapy (CRT) for rectal cancer may have an attritional impact on body composition and functional status, affecting postoperative outcomes. This prospective study characterized changes in body composition, muscle strength, and physical performance in patients with rectal cancer receiving CRT. METHODS: Body composition measures by a bioelectrical impedance analysis, hand grip strength (HGS), gait speed, and the nutritional status by the Mini-Nutritional Assessment (MNA) were assessed at Weeks 0 (pre-CRT), 2, 4, 6, and 10 (post-CRT). The pre-sarcopenic status was defined as low muscle mass alone and the sarcopenic status as low muscle mass and low muscle strength or function. RESULTS: The median age of 38 enrolled patients (25 men) was 59 years. The mean body fat mass, phase angle, and non-dominant HGS significantly decreased by 1.3 kg, 0.3°, and 0.7 kg, respectively, after CRT. Skeletal muscle mass and the MNA slightly decreased, while gait speed did not change. Significant reductions were observed in body fat mass (2.3 kg, p = 0.04) and non-dominant HGS (1.3 kg, p < 0.01) in women, while slight decreases were noted in men. Although no significant changes were detected in the pre- and post-CRT sarcopenic status in men (4 pre-sarcopenic patients), the numbers of pre-sarcopenic and sarcopenic female patients increased from pre-CRT (1 and 0) to post-CRT (1 and 2). CONCLUSION: Muscle strength and body fat decreased in patients receiving CRT, particularly women. These exploratory data provide a foundation for future investigations into the clinical utility of sex-sensitive therapeutic approaches.