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Relationship between Body Composition Changes, Inflammation and Physical Functionality in Head and Neck Cancer Patients Undergoing Concurrent Chemo‐Radiation
Author(s) -
Silver Heidi J,
Horn Paige S,
Murphy Barbara A
Publication year - 2006
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.20.4.a143-b
Subject(s) - medicine , lean body mass , weight loss , head and neck cancer , head and neck , concomitant , body weight , inflammation , cancer , gastroenterology , obesity , surgery
Loss of lean body mass (LBM) leads to physical frailty and functional dependence. We characterized the composition of weight lost in patients with locally advanced head and neck tumors undergoing concomitant chemoradiation(CCR), and determined whether LBM loss was related to inflammatory factors and/or poor physical function outcomes. Seventeen head and neck cancer patients aged 51–69 years had DEXA scans and serum CRP, TNF‐á, IL‐1β, IL‐6, IL‐8, IL‐10 and IL‐12p70 at 2‐weeks pre and 1 month post‐CCR. Functional status was self‐rated for 6ADLs and 6IADLs as “no,” “partial,” or “full” assistance. Physical performance was scored using Reuben’s Physical Performance Test. Total physical activity level (PAL) was scored using the Modified Baecke Physical Activity Questionnaire. From 66–80% of body mass loss was LBM, average decrease was 6.8kg in 3 mos., p<.0001. LBM loss was associated with greater ADL assistance (r=−.58, p=.02) and increased time for physical tasks (r=−.71, p=.004). PAL decreased (5.3±4.6 vs 1.6±1.7, p=.003). CRP doubled from 5.0±5.4 to 10.3±10.4 mg/dl, trending to significance, p=.09. Increased pro‐inflammatory cytokines IL‐6 and IL‐1β were associated with greater ADL and IADL assistance (r=.56, p=.04 and r=.60, p=.02, respectively). Decreased anti‐inflammatory cytokine IL‐10 was associated with reduced PAL (r=−.63, p=.015). Head and neck cancer patients undergoing CCR experience substantial LBM loss with increasing inflammatory stress that impairs physical performance and reduces physical activity. Interventions targeting muscle anabolism and inflammatory state are needed to prevent physical and functional decline. Supported by IRG‐58‐009‐46 from American Cancer Society and M01RR‐00095 from NIH NCRR.