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Beyond body surface area: CT-derived body composition as a predictor of chemotherapy toxicity and survival in pancreatic ductal adenocarcinoma: a systematic review
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DOI：10.1016/j.ctrv.2026.103174.png)
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Abstract
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• CT-based SMI, SMD, VAT and SAT are superior to BSA for chemotherapy toxicity risk prediction in PDAC. • Sarcopenia and myosteatosis together predict significantly higher odds of grade ≥3 toxicity • LBM-normalised nab-paclitaxel dosing (>5.83 mg/kg) predicts toxicity better than BSA dosing. • Early sarcopenia progression is a stronger mortality predictor than baseline muscle mass • Randomised trials are needed to validate body composition–guided dosing in clinical practice.
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