Tomografía computarizada a nivel de C3 y dinamometría como técnicas de diagnóstico de sarcopenia en pacientes con cáncer de cabeza y cuello

• Muresan, Bianca Tabita ^[3] ; Sánchez Juan, Carlos ^[1] ; Artero, Ana ^[3] ; Montoro, Alegría ^[2] ; Garcia Miragll, Enrique ^[4] ; Ruiz, Yesica ^[3] ; Soriano del Castillo, José Miguel ^[5] ; Ríos Ríos, Jaime ^[6] ; Hervás, David ^[2] ; López-Torrecilla, José ^[7]
  1. [1] Universitat de València

     Universitat de València

     Valencia, España

     
  2. [2] Instituto de Investigación Sanitaria La Fe

     Instituto de Investigación Sanitaria La Fe

     Valencia, España

     
  3. [3] Servicio de Endocrinología y Nutrición, Hospital General Universitari. Valencia, España.
  4. [4] Departamento de Oncología Radioterápica ERESA, Hospital General Universitari.
  5. [5] Unidad Mixta de Investigación en Endocrinología, Nutrición y Dietética Clínica, Universitat de València-Instituto de Investigación Sanitaria La Fe. Valencia, España.
  6. [6] Departamento de Medicina Familiar y Comunitaria, Hospital Clínic Universitari de València. Valencia, España.
  7. [7] Departamento de Oncología Radioterápica ERESA, Hospital General Universitari. Valencia, España.

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• Localización: Revista española de nutrición humana y dietética, ISSN 2173-1292, Vol. 24, Nº. 2, 2020 (Ejemplar dedicado a: Revista Española de Nutrición Humana y Dietética), págs. 90-102
• Idioma: español
• DOI: 10.14306/renhyd.24.2.927
• Títulos paralelos:
  • Computed tomography at C3 level and dynamometry as techniques for the diagnosis of sarcopenia in head and neck cancer patients
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• Resumen
  • español

    Introducción: Estudio piloto que determina el diagnóstico de sarcopenia mediante tomografía computarizada (TC) a nivel de la tercera vértebra cervical (C3) y dinamometría en pacientes con cáncer de cabeza y cuello. Comparación de la masa magra (MM) determinada mediante TC con técnicas clásicas de antropometría y dinamometría.Material y métodos: Se analizó la MM y el tejido adiposo mediante TC a nivel de C3 en 37 pacientes oncológicos mediante Unidades Hounsfield (UH). Posteriormente, se calculó el índice musculoesquelético (IME) y se determinó la fuerza prensora de mano para la determinación de sarcopenia. Por último, se comparó el IME mediante técnicas de valoración antropométrica clásica y dinamometría. Resultados: El 59,46% de los pacientes presentaron un IME (cm2/m2) disminuido, el 64,86% dinapenia, el 54,05% sarcopenia, el 32,43% sarcopenia dentro del sobrepeso y obesidad.  Por otro lado, la media de la masa grasa intermuscular fue 6,69 (3,8) cm2, y la masa grasa intramuscular 2,06 (1,11) cm2. Además, se encontró una asociación estadísticamente significativa entre la fuerza tanto en la mano fuerte (estimado = 0,412, IC95% [0,219; 0,605], p-valor <0,001) como en la mano débil (estimado =0,289, IC95% [0,123; 0,454], p-valor <0,001) y el IME cm2/m2. Respecto a la circunferencia muscular braquial), no alcanzamos a mostrar correlación positiva.Conclusiones: Nuestro estudio muestra que en el paciente con cáncer de cabeza y cuello la prevalencia de sarcopenia es elevada. Además, la depleción muscular evaluada mediante TC a nivel de C3 y dinamometría presenta cierta correlación, por lo que, aquellos pacientes con mayor depleción muscular a nivel de C3 presentan menor funcionalidad.

  • English

    Introduction: A pilot study that tried to diagnosis sarcopenia by computed tomography (CT) at the third cervical vertebra (C3) and dynamometry in head and neck cancer patients. Comparison of the muscle mass (MM) determined by CT, with classical anthropometric measure and dynamometry techniques.Material and methods: MM and adipose tissue were analyzed by CT at C3 level in 37 oncological patients using Hounsfield Units (HU). Consequently, skeletal muscle index (SMI) and handgrip was determined for the diagnosis of sarcopenia. Finally, SMI was compared by classical anthropometric techniques, as well as by dynamometry.Results: 59.46% of the sample presented a decreased SMI (cm2/m2), 64.86% dynapenia, 54.05% sarcopenia, and 32.43% sarcopenic obesity. On the other hand, mean intermuscular adipose tissue was 6.69 (3.8) cm2, and mean intramuscular adipose tissue 2.06 (1.11) cm2.  In addition, a statistically significant association was found between SMI and strength in strong hand (estimate = 0.412, 95% CI [0.219, 0.605], p-value <0.001) and in the weak hand (estimate = 0.289, IC95% [0.123, 0.454], p-value <0.001). Regarding the branchial muscle circumference, we did not reach to demonstrate a positive correlation.Conclusions: Our study indicates that in head and neck cancer patients there is a high prevalence of sarcopenia. In addition, muscle depletion assessed by CT scans and dynamometry have demonstrate positive correlation, and consequently, those patients with greater muscle depletion at the C3 level have less muscle functionality.

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