Jager-Wittenaar Harriët, Dijkstra Pieter U, Dijkstra Gerard, Bijzet Johan, Langendijk Johannes A, van der Laan Bernard F A M, Roodenburg Jan L N
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Nutrition. 2017 Mar;35:114-118. doi: 10.1016/j.nut.2016.11.008. Epub 2016 Dec 14.
In patients with cancer, weight loss can be related to simple starvation, disturbed metabolism, or both. In patients with head and neck cancer (HNC), weight loss often is attributed to simple starvation because the obvious oral symptoms are known to hinder dietary intake. In this population, cachexia remains a relatively unexplored phenomenon. The aim of this study was to explore the prevalence of cachexia and precachexia in patients with newly diagnosed HNC.
Fifty-nine patients with newly diagnosed HNC were asked to participate in the prospective cohort study, from which only baseline data were used in the analyses. Measurements were performed 1 wk before cancer treatment, that is, cachexia status by Fearon's cancer-specific framework, dietary intake, muscle mass, muscle strength, and biochemical markers (C-reactive protein, albumin, hemoglobin, interleukin-1β, interleukin-6, and tumor necrosis factor-α) were assessed.
Data of 26 patients were included in the analyses (59% participation rate). Forty-two percent of the patients (n = 12) were classified as cachectic and 15% (n = 4) as precachectic. Muscle mass depletion was significantly more frequent in cachectic patients (67%) than in noncachectic patients (14%; P = 0.014). No differences in inflammatory markers were observed between cachectic and noncachectic patients.
This exploratory study suggested a high prevalence of cachexia (42%) in patients with newly diagnosed HNC. Although a large study is needed to further elucidate the role of cachexia in patients with HNC, the data presented here suggest that cachexia is a common problem in this patient population, which has therapeutic and prognostic implications.
在癌症患者中,体重减轻可能与单纯饥饿、代谢紊乱或两者都有关。在头颈癌(HNC)患者中,体重减轻通常归因于单纯饥饿,因为已知明显的口腔症状会妨碍饮食摄入。在这一人群中,恶病质仍然是一个相对未被充分研究的现象。本研究的目的是探讨新诊断的HNC患者中恶病质和恶病质前期的患病率。
59例新诊断的HNC患者被要求参与前瞻性队列研究,分析中仅使用基线数据。在癌症治疗前1周进行测量,即根据费伦的癌症特异性框架评估恶病质状态、饮食摄入、肌肉质量、肌肉力量和生化标志物(C反应蛋白、白蛋白、血红蛋白、白细胞介素-1β、白细胞介素-6和肿瘤坏死因子-α)。
26例患者的数据纳入分析(参与率59%)。42%的患者(n = 12)被分类为恶病质,15%(n = 4)为恶病质前期。恶病质患者的肌肉质量消耗明显比非恶病质患者更频繁(67%比14%;P = 0.014)。恶病质患者和非恶病质患者之间未观察到炎症标志物的差异。
这项探索性研究表明,新诊断的HNC患者中恶病质的患病率很高(42%)。尽管需要进行大规模研究以进一步阐明恶病质在HNC患者中的作用,但此处呈现的数据表明,恶病质在这一患者群体中是一个常见问题,具有治疗和预后意义。