Computational Oncology Laboratory, Imperial College London, London, UK
Department of Radiotherapy, Charing Cross Hospital, London, UK.
BMJ Open. 2021 Jul 2;11(7):e053076. doi: 10.1136/bmjopen-2021-053076.
Sarcopenia is the loss of skeletal muscle volume or quality, a concept previously established in age-related frailty. Sarcopenia is part of the cancer cachexia syndrome and has therefore been explored as biomarker through the opportunistic measurement of skeletal muscle from routine cancer imaging. However, there is inconsistency in diagnostic landmarks and cut-offs. The most common assessment method is skeletal muscle area at the slice level of the third lumbar vertebrae divided by height squared. Alternative sarcopenia measures have been derived from morphological descriptions of the psoas, thoracic and cervical muscles, driven by tumour-specific anatomical imaging.Current tumour-site specific reviews suggest a link between heterogeneously defined sarcopenia on tumour site-specific outcomes. Because lack of uniformity, a scoping review is best suited to streamline anatomically based definitions and map the evidence to outcomes. The aim of this article is to describe a protocol for a scoping review that will homogenise the evidence of radiological sarcopenia in cancer. The extent, range and nature of reports will be examined, after which possible titles for potential systematic reviews identified.
We will apply methods based on the Joanna Briggs Institute scoping review manual. Predefined search terms compiled with a librarian experienced in systematic reviews will be used to search PubMed/Medline, Embase, Scopus and Cochrane databases studies correlating cross-sectional cancer sarcopenia biomarkers with clinical outcomes. Studies will be mapped according to whether they have defined new sarcopenia measures or applied previous definitions to new populations, both with reported outcomes. This review will generate a numerical analysis on the extent of cancer sarcopenia measures as well as a narrative synthesis to describe the applications of radiologically derived sarcopenia in cancer.
Formal ethical approval was not required to undertake this scoping review. Findings will be published in peer-reviewed journals and conference presentations.
肌肉减少症是骨骼肌体积或质量的丧失，这一概念以前是在与年龄相关的虚弱中确立的。肌肉减少症是癌症恶病质综合征的一部分，因此已通过从常规癌症成像中机会性测量骨骼肌来作为生物标志物进行了探索。但是，诊断标志物和切点不一致。最常见的评估方法是第三腰椎切片水平的骨骼肌面积除以身高的平方。从腰部、胸部和颈部肌肉的形态描述中衍生出了替代的肌肉减少症测量方法，这是由特定于肿瘤的解剖成像驱动的。目前基于肿瘤部位的综述表明，肿瘤部位特异性结局中存在异质定义的肌肉减少症之间存在关联。由于缺乏一致性，范围综述最适合简化基于解剖的定义，并将证据映射到结局。本文的目的是描述一项用于癌症放射学肌肉减少症的范围综述方案，以统一放射学肌肉减少症的证据。将检查报告的范围、幅度和性质，然后确定可能的系统综述标题。
我们将采用基于 Joanna Briggs 研究所范围综述手册的方法。与具有系统综述经验的图书馆员合作编制的预定义搜索词将用于搜索 PubMed/Medline、Embase、Scopus 和 Cochrane 数据库中与临床结局相关的横断面癌症肌肉减少症生物标志物的研究。将根据是否定义了新的肌肉减少症测量方法或是否将以前的定义应用于新的人群，以及是否报告了结果，对研究进行映射。本综述将对癌症肌肉减少症测量的程度进行数值分析，并进行叙述性综合描述放射学衍生的肌肉减少症在癌症中的应用。
进行这项范围综述不需要正式的伦理批准。研究结果将发表在同行评议的期刊和会议报告中。
