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Buntzel J.,Head & Neck Surgery | Buntzel J.,German Working Group Trace Elements and Electrolytes in Oncology | Micke O.,Franziskus Hospital | Micke O.,German Working Group Trace Elements and Electrolytes in Oncology | And 13 more authors.
Trace Elements and Electrolytes | Year: 2010

Objective: The substitution of selenium effects in activation of the selenium dependent enzyme glutathione peroxidase which is important for scavenging free radicals. Until today only limited data was available about the clinical impact of selenium regarding the toxicities due to free radical producing therapies, e.g. irradiation or chemotherapy. Material and methods: 39 patients (8 female, 31 male) with advanced head neck cancer were included to a randomized Phase II study. The mean age was 63.52 ± 9.31 years. Tumor localizations: oral cancer 15 patients, oropharynx 19 patients, hypopharynx 5 patients, CUP 1 patient. Group A (n = 22) received 500 μg sodium selenite at the days of radiotherapy and 300 μg sodium selenite at holidays or weekend. Group B (17) was irradiated without any selenium substitution. Both groups were well balanced according age, gender, localization and stage of the tumor. We evaluated the RTOG grade of radiation-associated toxicities once per week. Results: We observed the following serious toxicities (Group A versus Group B): dysphagia 22.7% vs. 35.3%, loss of taste 22.7% vs. 47.1%, dry mouth 22.7% vs. 23.5%, and stomatitis 36.4% vs. 23.5%. A statistical trend (Fisher's exact-test) is only seen in the area of loss of taste (p = 0,172). The analysis per week (Student t-test) had shown a significant reduction of dysphagia in the selenium group at the last week of irradiation. Conclusion: The small randomized trial has shown limited effects of selenium in the prevention of ageusia (loss of taste) and dysphagia due to radiotherapy because of head and neck cancer. ©2010 Dustri-Verlag Dr. K. Feistle.

Buntzel J.,Head & Neck Surgery | Buntzel J.,German Working Group Trace Elements and Electrolytes in Oncology | Buntzel H.,Sudharz Krankenhaus Nordhausen gGmbH | Micke O.,Franziskus Hospital | And 12 more authors.
Trace Elements and Electrolytes | Year: 2011

Objective: The use of complementary and alternative methods is common in oncology, but nothing is known about the role ofCAMin the last days of a patient's life. Material and methods: Between 1-2007 and 10-2008 the palliative care team treated 85 patients (50 male, 35 female, median age 62 years) on out-door basis. All families were asked to complete a structured questionnaire regarding the use of CAM during the last period of the patient's life. Patients suffered from cancer in 83/85 patients (98%), 2 patients had neurologic disorders. Results: Only 20 families (31%) have not used any CAM. Spiritual support (praying, hospice services) was asked for by 60/85 families (71%). 25/85 families (29%) reported drug use. Favorite methods were vitamins (n = 11, 13%), trace elements (n = 9, 11%), and mistletoe (n = 8, 9%). 30 patients (35%) were treated by physiotherapy (28 oncology patients, 2 neurology patients). Logopedy and ergotherapy were used in 10 patients (12%). 12 families (14%) reported use of aroma-therapy in patient's care. The main information source was the GP (house physician) (45/85, 53%)), followed by the palliative care team (30/85, 35%) and pharmacies (27/85, 32%). Internet, journals or self-service information were only used by 25/85 families (29%). The effectivity of the categorized methods was estimated between 1 and 5 (very good - worthy) by the patients or their families. The following ranking was registered: spiritual support 2.4; physical therapy 2.7, logopedy/ergotherapy 3.1, drugs 3.3. 65/85 families (76%) were satisfied with the information received from the health care practitioners. Conclusion: Complementary methods are often practiced during the last days of a patients life. Families and friends are looking for valid information and need help from the professionals. The different methods have been evaluated regarding effectivity as well as acceptance by the patients. ©2011 Dustri-Verlag Dr. K. Feistle.

Buntzel J.,Head & Neck Surgery | Buntzel J.,German Working Group Trace Elements and Electrolytes in Oncology | Knolle U.,Head & Neck Surgery | Garayev A.,Head & Neck Surgery | And 12 more authors.
Trace Elements and Electrolytes | Year: 2010

During the last few years we have collected data showing a relation between status of the disease and the serum concentrations of different trace elements. Are they able to monitor the disease as tumor markers? In a first study 100 untreated head and neck cancer patients were characterized by decreased levels of selenium, zinc and iron. Copper was the only increased. During the radiotherapy no changes of serum concentrations were seen. A further analysis had shown the differences between resectable and non-resectable tumors. As larger primary tumors were examined, the concentration of selenium in the serum of our patients decreased. These findings are supported by new data of NMR-tumor volumetry and trace elements concentrations in 21 patients. The relation between serum-selenium and tumor volume is stronger than between classical tumor markers (SCC; CEA, CYFRA 21-1) and the tumor volume. A last investigation has suggested that a destroyed homeostasis of trace elements is a sign of a pre-terminal ill patient. When the destroyed homeostasis is observed, the patient has a window of 4-6 weeks of remaining life time. Conclusions: Trace element status offers a lot of information about the course of the disease and the individual. But environmental factors have more impact on this trace element status than on other classical tumor markers. ©2010 Dustri-Verlag Dr. K. Feistle.

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