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Explorative study on the predictive value of systematic inflammatory and metabolic markers on weight loss in head and neck cancer patients undergoing radiotherapy

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Abstract

Purpose

This study aimed to explore the predictive value of systematic inflammatory and metabolic markers in head and neck (H&N) cancer patients during radiotherapy (RT).

Methods

Twenty-seven patients were evaluated. The protocol included serial blood tests [highly sensitive C-reactive protein (hsCRP), albumin, insulin-like growth factor 1 (IGF-1), IGF binding protein 1 (IGFBP-1) and ghrelin], measurements of body weight and assessment of oral mucositis.

Results

The mean nadir of weight loss was observed at the end of RT. At the time of diagnosis, mean hsCRP was 5.2 ± 1.0 mg/L. HsCRP significantly increased during RT and decreased during the post-RT period. Mean maximum hsCRP was 35.8 ± 8.5 mg/L, with seven patients reaching >40 mg/L. A numerical decrease of albumin (by 18.2%) and only small changes in IGF-1, IGFBP-1 and ghrelin levels were observed. None of the metabolic parameters was significantly associated with weight loss.

Conclusions

HsCRP increased in response to RT for H&N cancer as a sign of irradiation-induced inflammation. Weight loss was not preceded by changes of the metabolic parameters, indicating that assessment of the blood markers used in this study is of little value. Regular body weight measurement and assessment of oral mucositis are feasible, cheap and important procedures to control the metabolic homeostasis during RT.

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Acknowledgements

The study was supported by grants from the Swedish Cancer Society and the Swedish Laryngeal Cancer Foundation.

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Authors and Affiliations

  1. Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

    Ylva Tiblom Ehrsson

  2. Department of Medical Science, Uppsala University Hospital, 751 85, Uppsala, Sweden

    Per M. Hellström

  3. Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, Sweden

    Kerstin Brismar

  4. Department of Oncology, Karolinska University Hospital, 118 83, Stockholm, Sweden

    Lena Sharp

  5. School of Medical and Health Sciences, Örebro University, 701 82, Örebro, Sweden

    Ann Langius-Eklöf

  6. Department of Clinical Sciences, Umeå University, 901 87, Umeå, Sweden

    Göran Laurell

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  1. Ylva Tiblom Ehrsson
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  2. Per M. Hellström
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Correspondence to Ylva Tiblom Ehrsson.

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Ehrsson, Y.T., Hellström, P.M., Brismar, K. et al. Explorative study on the predictive value of systematic inflammatory and metabolic markers on weight loss in head and neck cancer patients undergoing radiotherapy. Support Care Cancer 18, 1385–1391 (2010). https://doi.org/10.1007/s00520-009-0758-4

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  • DOI: https://doi.org/10.1007/s00520-009-0758-4

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