Impact of Body Composition in Curative Radiotherapy
Research type
Research Study
Full title
Analysing the impact of body composition on treatment outcomes for patients receiving curative radiotherapy.
IRAS ID
359614
Contact name
Alexander Vickers
Contact email
Sponsor organisation
The University of Manchester
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Sarcopenia describes the degenerative loss of muscle mass and strength, and impaired physical performance, and is associated with ageing, malnutrition, inflammatory disease and malignancy. Reduced muscle quality (with increased intramuscular adipose tissue) often precedes reduced muscle quality. In oncology patients, both reduced muscle mass and muscle quality are emerging pan-cancer prognostic biomarkers for increased treatment toxicity and inferior survival. A recent systematic review examining the prognostic significance of sarcopenia in patients undergoing radiotherapy demonstrated mixed results in the existing literature, likely due to the inclusion of small underpowered studies, heterogenous and cohort specific definitions for sarcopenia and using poor statistical methodological design for identifying associations of body composition with treatment outcomes.
The gold standard for quantifying muscle mass, is measuring the area of all muscle groups at the L3 vertebral level and then correcting for patient height to give a skeletal muscle index (SMI). Both subcutaneous (SAT) and visceral (VAT) adipose tissue mass can be quantified in the same way and can identify more subtle body composition changes than current stand-of-care measures such as weight, body mass index (BMI), waist circumference and waist to hip ratio. In addition, we can measure intramuscular adipose tissue (IMAT) mass or muscle density. The measurement of muscle and fat at L3 does require a CT scan, which for many treatment pathways, and in particular cancer pathways where this project focuses, is now the case.
Our aim is to demonstrate that body composition changes are prognostic in patients undergoing radiotherapy-based treatments, and to identify patients who are at high risk of poor outcomes. This would provide rationale for introducing streamlined body composition analysis into routine clinical practice and allow for individualisation of treatment plans and targeted therapeutic approaches to improve outcomes.
REC name
Wales REC 7
REC reference
25/WA/0315
Date of REC Opinion
27 Oct 2025
REC opinion
Favourable Opinion