Radiotherapy RheinMainNahe, 55543 Bad Kreuznach, Germany.
Department of Radiotherapy and Radiation Oncology, Marien Hospital Herne, Ruhr University Bochum, 44801 Bochum, Germany.
Nutrients. 2018 Apr 13;10(4):483. doi: 10.3390/nu10040483.
Se measurement and supplementation in radiation oncology is a controversial issue. The German Working Group Trace Elements and Electrolytes in Oncology (AKTE) has conducted a number of studies on this issue, which are summarized in this review. Strategies have been tested and developed, aiming to stratify the patients with a potential need for supplemental Se and how best to monitor Se supplementation with respect to health effects and risks. We analyzed blood and tissue Se-levels of different tumor patients ( = 512). Two randomized phase III clinical studies were conducted for testing a potential radioprotective effect of supplemental Se during radiation therapy in patients with uterine cancer ( = 81) and head and neck tumor patients ( = 39). A relative Se deficit in whole blood or serum was detected in the majority of tumor patients (carcinomas of the uterus, head and neck, lung, rectal or prostate cancer). In prostate cancer, tissue Se concentrations were relatively elevated in the carcinoma centre as compared to the surrounding compartment or as compared to tumor samples from patients with benign prostatic hyperplasia. Adjuvant Se supplementation successfully corrected Se-deficiency in the patients analyzed and decreased radiotherapy-induced diarrhea in a randomized study of radiotherapy patients with carcinomas of the uterus. Survival data imply that Se supplementation did not interfere with radiation success. Some positive effects of supplemental Se in the prevention of ageusia (loss of taste) and dysphagia due to radiotherapy were noted in a second randomized trial in patients with head and neck cancer. We have not observed any adverse effects of supplemental Se in our studies. Se supplementation yielded promising results concerning radioprotection in tumor patients and should be considered as a promising adjuvant treatment option in subjects with a relative Se deficit.
在放射肿瘤学中,硒的测量和补充是一个有争议的问题。德国肿瘤微量元素和电解质工作组(AKTE)已经对此问题进行了多项研究,本综述对此进行了总结。已经测试和开发了策略,旨在对有潜在硒补充需求的患者进行分层,并确定如何最好地监测硒补充对健康影响和风险。我们分析了不同肿瘤患者(= 512)的血液和组织硒水平。进行了两项随机 III 期临床研究,以测试在子宫癌(= 81)和头颈部肿瘤患者(= 39)放疗期间补充硒的潜在放射防护作用。大多数肿瘤患者(子宫癌、头颈部癌、肺癌、直肠癌或前列腺癌)的全血或血清中均发现相对硒缺乏。与周围组织或与前列腺增生症患者的肿瘤样本相比,前列腺癌中心的组织硒浓度相对较高。辅助硒补充成功纠正了分析患者的硒缺乏,并在子宫癌放疗患者的随机研究中减少了放疗引起的腹泻。生存数据表明,硒补充没有干扰放疗的成功。在对头颈部癌患者的第二项随机试验中,观察到补充硒在预防放疗引起的味觉丧失和吞咽困难方面有一些积极作用。在我们的研究中,没有观察到补充硒的任何不良反应。硒补充在肿瘤患者的放射防护方面取得了有希望的结果,并且应该被认为是具有相对硒缺乏的受试者的一种有前途的辅助治疗选择。