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Lemgo, Germany

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 | 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.

Buntzel J.,Head & Neck Surgery | Buntzel J.,German Working Group Trace Elements and Electrolytes in Oncology AKTE | Knolle U.,Sudharz Krankenhaus Nordhausen | Knolle U.,German Working Group Trace Elements and Electrolytes in Oncology AKTE | And 8 more authors.
Trace Elements and Electrolytes | Year: 2011

Objective: Is there a relation between tumor volume and SCC/CEA/CYFRA 21-1 and/or trace element status (selenium, zinc) in patients with advanced head and neck cancer? Material and methods: Before starting the treatment we performed magnetic resonance imaging (MRI) based tumor volumetry in 21 patients (3 female, 18 male) suffering from advanced head and neck cancer. The following tumor localizations were included - oropharynx 6 patients (pts), cavum oris 5 pts, hypopharynx 6 pts, others 4 pts. At the time of diagnosis classical tumor markers SCC, CEA, CYFRA 21-1 were measured as well as the serum-concentrations of selenium and zinc (atom absorption spectrometry). Relations between tumor volume and laboratory data were calculated with MS Excel. Results: The median tumor volume of the primary tumor was 16.45 cm3 (range 1.14-209.87 cm3). We have seen reduced zinc in 6/21 patients (28.6%) and selenium 16/21 patients (76.1%). Increased values were observed in 14/21 cases for SCC (66.7%), 1/21 cases for CEA (4.8%), and 4/21 cases for CYFRA21-1 (19%). These sensitivities were increased to 50% for Zn, 83.3% for Se, 75% for SCC, 8.3% for CEA, and 16.7% for CYFRA 21-1 if the tumor volume was > 10 cm3 (n = 12). Conclusion: SCC and serum selenium seem to be effective tumor markers in head neck cancer patients with primary tumor volumes > 10 cm3. ©2011 Dustri-Verlag Dr. K. Feistle.

Schmitz C.,Klinikum Lippe Lemgo | Schramm S.,Klinikum Lippe Lemgo | Hankiss J.,Klinikum Lippe Lemgo
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2011

This case-report shows our experience with a patient, who underwent mesh hernioplasty followed by infection of the mesh and full-thickness loss of the abdominal wall after debridement due to necrosis. The anamnesis included generalised arteriosclerosis, chronic nicotine and alcohol abuse and recurring wound-healing disorders after surgical procedures. The initial infection was treated by radical debridement, targeted antibiotics and V.A.C.® Therapy. After this, a staged plastic reconstructive procedure with four pedicled flaps was performed. The functional integrity of the abdominal wall was completely re-established. The patient was able to continue her occupation as a facility manager. Although the use of free flaps is very common in modern plastic and reconstructive surgery, procedures such as pedicled flaps still have their significance for special indications. In this case, a full recovery of the abdominal wall with autologous tissue was successful under difficult vascular conditions by using local flaps. © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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