# Prediction of hematologic toxicity in luminal type breast cancer patients receiving neoadjuvant chemotherapy using CT L1 level skeletal muscle index

## TL;DR

This study finds that a low skeletal muscle index in luminal-type breast cancer patients is linked to severe blood-related side effects during chemotherapy.

## Contribution

The study identifies CT-L1 skeletal muscle index as a viable alternative to CT-L3 for predicting hematologic toxicity in breast cancer patients.

## Key findings

- Low skeletal muscle index (<32.91 cm²/m²) is an independent risk factor for severe hematologic toxicity.
- Initial tumor size ≥3.335 cm and high glucose-to-neutrophil ratio (≥2.88) also increase toxicity risk.
- CT-L1 body composition analysis correlates with CT-L3 parameters and can predict toxicity outcomes.

## Abstract

This study aims to explore the correlation between the CT-L1 and L3 body composition parameters and analyze the relationship between L1 body composition and hematologic toxicity in luminal-type breast cancer patients undergoing neoadjuvant chemotherapy. Data from 140 luminal-type breast cancer patients who underwent surgical treatment after neoadjuvant chemotherapy were analyzed retrospectively. Spearman analysis was used to assess the correlation between CT-L1 and CT-L3 body composition parameters pre-neoadjuvant chemotherapy. Additionally, univariate and multivariate logistic regression analyses were performed to identify factors influencing hematologic toxicity. CT-L1 body composition parameters were positively correlated with CT-L3 body composition parameters in 34 patients. Severe hematological toxicity occurred in 46 cases among the patient cohort. A skeletal muscle index (SMI) of < 32.91 cm2/m2, initial tumor size ≥ 3.335 cm, and a glucose-to-neutrophil ratio (GLR) ≥ 2.88 were identified as independent risk factors for severe hematologic toxicity during neoadjuvant chemotherapy in luminal-type breast cancer patients. The sample size in this study is small, and the predictive capacity of GLR in hematologic toxicity requires further research for comprehensive validation. CT-L1 analysis represents a viable alternative to CT-L3 analysis for body composition assessment. Patients with a low skeletal muscle index were more prone to experiencing severe hematologic toxicity during neoadjuvant chemotherapy.