151751-Najiba-Chargi

238 CHAPTER 13 its ability to draw conclusions for a large population of cancer patients 4,5,7 To conclude whether this predictive value of low SMM is present across cancer types and treatments, studies have to be performed in a larger and wider population. This systematic review aims to provide a comprehensive overview of the literature and data regarding the predictive value of low SMM for anti-cancer drug toxicity and analyze the overall effect in ameta-analysis. Specifically, this reviewwill investigate whether this predictive value is universal across cancer types. Additionally, this review will study if there is a relationship between drug distribution and the predictive value of low SMM for anti-cancer drug toxicity. METHODS SEARCH STRATEGY The systematic reviewwas conducted according to the Preferred Reporting Items for System- atic Reviews and Meta-Analyses (PRISMA) standards. 18 A systematic search was performed in four electronic databases, which are MEDLINE, EMBASE, Cochrane, and Scopus, from inception through 17 February 2020. The search terms included toxicity, sarcopenia, chemotherapy, cancer, and synonyms for each of these terms detailed in Appendix A. The references of each included article were also screened to identify additional records. STUDY SELECTION The studies obtained from the systematic search were assessed by screening titles and ab- stracts, by a single researcher (L.F.J.H.) Subsequently, the potentially included articles were assessed using the full text. Studies were included in the analysis when they met the following inclusion criteria: (1) examine the association of lowSMMand anti-cancer drug toxicity, (2) eval - uate skeletal muscle mass by measuring cross-sectional area on CT or MRI, (3) are published in English, and (4) describe studies in humans only. Studies were excluded from the analysis when they met the following exclusion criteria: (1) do not normalize SMM for height; (2) are a systematic review, conference paper, or study protocol; or (3) only describe an intervention and its effects on SMM or toxicity. DATA EXTRACTION The data were extracted and collected from each included study. This consisted of (1) author and publication year, (2) population size and cancer type, (3) occurrence and definition of low SMM, (4) technique used for the evaluation of SMM (such as scan type, software for image anal - ysis, and vertebrae level analyzed), (5) treatment specifications (anti-cancer drug, curative or palliative intent, primary or adjuvant, and combination with radiotherapy), (6) time between scan and treatment, (7) measure and occurrence of toxicity. Only published data was included.