ABSTRACT
The aim of the study was to determine the prevalence of cancer cachexia according to the clinical stage and determine differences in body composition, usual energy intake, and pro-inflammatory profile between cachectic and non-cachectic patients newly diagnosed with head and neck squamous cell carcinoma (HNSCC). A cross-sectional study was conducted in adult patients diagnosed with HNSCC admitted to the oncology unit before starting cancer treatment. Cancer cachexia was assessed according to Fearon criteria, and patients were divided into two groups: cachectic and non-cachectic patients. Body composition measured by bioelectrical impedance, energy intake, and biochemical and inflammatory markers were assessed. Comparative analyses were performed Student's-T test, using one-way ANOVA, chi-square and Mann Whitney-U test. Of the 79 consecutive patients included in the analysis, 72% (n = 57; 61 ± 15 years) were classified as cachectic and 28% (n = 22;59 ± 10 years) as non-cachectic. According to clinical stage, the prevalence of cachexia was stage I = 8.8%, stage II = 15.8%, stage III = 33.3% and stage IV = 42.1% (P = 0.564) and phase angle showed to be different between these groups (P < 0.05). Body composition showed that fat-free mass and total body water were significantly lower in patients with cachexia (p < 0.05). No differences were observed in phase angle, food intake or inflammatory markers between cachectic and non-cachectic patients. Cancer-cachexia is prevalent in all clinical stages in newly diagnosed patients with HNSCC. Early identification of cancer cachexia will allow initiate specialized nutrition support in a timely manner.
Subject(s)
Cachexia , Head and Neck Neoplasms , Cachexia/diagnosis , Cachexia/epidemiology , Cachexia/etiology , Cross-Sectional Studies , Head and Neck Neoplasms/complications , Humans , Prospective Studies , Squamous Cell Carcinoma of Head and NeckABSTRACT
INTRODUCTION: Head and neck cancer patients are at high risk of anorexia-cachexia syndrome and literature shows that Eicosapentaenoic acid (EPA) could regulate it. We aim to determine the EPA effect on body composition and pro-inflammatory markers in patients with head neck cancer. MATERIALS AND METHODS: A randomized single-blind placebo-controlled clinical trial was conducted in patients with head and neck squamous cell cancer who received a polymeric diet with 2 g of EPA or a standard polymeric diet for six weeks before antineoplastic treatment. We assessed body composition by bioelectrical impedance analysis and determined IL-1ß, IL-6, TNF-α and IFN-γ, CRP, serum proteins, and blood count at baseline and at the end of the study. RESULTS: 32 patients received EPA (2 g/day) and 32 became controls. A decrease in serum levels of IL-1ß, IL-6, TNF-α, and IFN-γ was observed in the experimental group, as well as regulation of body weight (-0.3 ± 5.9 vs. -2.1 ± 3.7), lean body mass (-0.2 ± 3.8 vs. -1.3 ± 3.6), body fat mass (0.2 ± 3.5 vs. -1.2 ± 3.8), and quality of life (10 ± 33 vs. 5 ± 34). CONCLUSION: Supplementing with 2 g/day of EPA to head and neck cancer patient during antineoplastic treatment regulates serum pro-inflammatory cytokines, body weight, lean body mass, and improve quality of life.
