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Buntzel J.,Head & Neck Surgery | Buntzel J.,German Study Group Trace Elements and Electrolytes in Oncology AKTE | Krauss T.,Zentralklinikum Suhl | Buntzel H.,Palliative Care Unit | And 10 more authors.
Trace Elements and Electrolytes | Year: 2012

Objective: Is there a relation between nutritional status and the prognosis of head and neck cancer patients? Which diagnostic procedures gives us sufficient information about the malnutrition of the individual? Material and methods: A first retrospective study analyzes the outcome of 110 patients in relation to initial weight loss and weight loss at the end of radiotherapy. A second study investigated the changing bioimpedance (BIA) data of 27 survivors and 39 patients who died between their first and last measurement during nutritional therapy (at least 4 weeks). Results: A critical initial weight loss is 10 kg or more at the point of diagnosis. At the end of radiotherapy the body mass reduction should be lower than 15 kg. Raw data of BIA reflects the changing nutritional status at the end of life. We observed a stabilized phase angle in survivors (4.7° to 5.2°) whereas dying patients have shown a significant decreased phase angle (4.6° to 3.7°, p < 0.05). Conclusion: The prognosis of head and neck cancer patients is tightly related to their nutritional status. Specific nutritional anamnesis (initial weight loss, total weight loss, BMI) and additional biophysical measurements are recommended to observe the individual status during the follow up. ©2012 Dustri-Verlag Dr. K. Feistle.

Buntzel J.,Head & Neck Surgery | Micke O.,Franziskus Hospital | Kisters K.,German Study Group Trace Elements and Electrolytes in Oncology AKTE | Bruns F.,Hannover Medical School | And 5 more authors.
Anticancer Research | Year: 2010

Objective: Selenium is an essential cofactor of the enzyme glutathione peroxidase (GSH-Px), which is important for the endogenous detoxification of free radicals. A reduced activity of GSH-Px is related to increased toxicities due to radiation therapy during primary cancer treatment. Therefore, selenium substitution may be a new supportive strategy to diminish radiation-associated side effects. Patients and Methods: The selenium blood concentrations of 121 radiotherapy patients were measured in two randomized observation studies (81 gynaecological tumours, 40 head and neck tumours). Measurements (atom absorption spectrometry) were performed on serum and whole blood (WB) samples before, in the middle of, at the end, and 6 weeks after radiotherapy. In cases of decreased selenium levels in WB, 63 patients (mean age 63.83±9.23 a) received selenium substitution (500 μg sodium selenite at RT days, 300 μg at the weekend) and 64 patients (mean age 63.03±10.47 years) were evaluated as control group without any selenium substitution. Both groups were well balanced according to tumour localization and stage. Reference values were 85-162 μg/l WB-selenium, and 65-135 μg/l serum-selenium. Results: We measured the following WB selenium (Se) levels (Se-group vs. control group, U-test): begin RT 64.17±13.98 μ/l vs. 64.50±14.47 μ/l (p=0.869); mid RT 92.48±26.68 μ/l vs. 65.80±18.04 μ/l (p<0.001); end RT 93.78±25.90 μ/l vs. 64.06±17.54 μ/l (p<0.001); 6 weeks after RT 74.01±20.06 μ/l vs. 69.66±17.83 μ/l (p=0.183). The serum levels were as follows: begin RT 59.18±13.49 μ/l vs. 61.99±15.72 μ/l (p=0.427); mid RT 104.75±31.41 μ/l vs. 62.37±16.23 μ/l (p<0.001); end RT 100.63±31.12 μ/l vs. 62.29±16.11 μ/l (p<0.001); 6 weeks after RT 72.73±26.53 μ/l vs. 64.17±17.22 μ/l (p=0.170). Conclusion: The used dosage of 500 μg sodium selenite per day is sufficient to treat selenium deficiency during radiotherapy. After substitution, the patient returns to their individual selenium status.

Buntzel J.,Head & Neck Surgery | Riesenbeck D.,Prosper Hospital Recklinghausen | Glatzel M.,German Study Group Trace Elements and Electrolytes in Oncology AKTE | Berndt-Skorka R.,Municipal Hospital Neubrandenburg | And 7 more authors.
Anticancer Research | Year: 2010

Objective: The substitution of selenium activates the selenium-dependent enzyme glutathione peroxidase, which is important for scavenging free radicals. To date, only limited data are available about the clinical impact of selenium regarding the toxicities due to free radical producing therapies, e.g. irradiation or chemotherapy, and therefore the objective of this study was to investigate the clinical impact of selenium in such therapies. Patients and Methods: 39 patients (8 female, 31 male) with advanced head and neck cancer were included in a randomised phase II study. The mean age was 63.52±9.31 years. Tumour localizations: oral cavity 15 patients, oropharynx 19 patients, hypopharynx 5 patients, carcinoma of unknown primary 1 patient. Group A (n=22) received 500 μ g sodium selenite on the days of radiotherapy and 300 μ g sodium selenite on days without radiotherapy. Group B (17) was irradiated without any selenium substitution. Both groups were well balanced according to age, gender, localization and stage of the tumour. The RTOG grade of radiation-associated toxicities was evaluated once per week. Results: The following serious toxicities were observed (group A vs. group B): dysphagia 22.7% vs. 35.3%, loss of taste 22.7% vs. 47.1%, dry mouth 22.7% vs. 235%, and stomatitis 36.4% vs. 23.5%. A statistical trend (Fisher's exact test) was only seen for the loss of taste (p=0.172). The weekly patient analysis (Student's t-test) showed a significant reduction of dysphagia in the selenium group (Group 1) at the last week of irradiation. Conclusion: This small randomised trial showed limited effects of selenium in the prevention of ageusia (loss of taste) and dysphagia due to radiotherapy of head and neck cancer.

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