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      Parameters of malnutrition and trace element status in head and neck cancer patients

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          Abstract

          Abstract. Objective: Is there any relationship between nutritional status and the status of trace elements in patients with advanced head and neck cancer? Material and methods: We have analyzed the register data of 42 head and neck cancer patients. Survival data of 22 women and 20 men were included. The mean age was 67.3 ± 10.77 years. Bioimpedance analysis (BIA) was measured by Biocorpus 4000 RX (MEDIcal Health Care GmbH, Karlsruhe, Germany) and was summarized in individual phase angle (PA) of each patient. Trace elements (selenium, zinc, iron) were measured in serum samples at the same time, so we got individual data sets for each patient. Results: Patients with normal PA > 5.0° have a significantly better survival (p = 0.016). The median survival time is 13.84 months (range 0.69 – 125.19) in malnourished patients (PA < 5.0) compared to 51.16 months (range 7.02 – 116.79) in normally nourished head and neck cancer (HNC) patients (PA > 5.0). Age-adjusted body mass index has a similar impact on prognosis (p = 0.068) in the investigated study groups. Trace element (TE) deficits are seen more often in PA < 5.0° patients for selenium (p = 0.064) and zinc (p = 0.116). No relationship between nutritional status and TE status was seen for iron. Conclusion: BIA is able to document the impact of malnutrition on survival in the group of head and neck cancer patients. Furthermore, it filters the selenium- and zinc-deficient patients.


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          Sex-age-specific association of body mass index with all-cause mortality among 12.8 million Korean adults: a prospective cohort study

          Background: Despite differences in body shape and adiposity characteristics according to sex and age, a single range of healthy weight [body mass index (BMI, kg/m2) of 18.5–24.9) regardless of sex and age has been recommended. The aim of the study is to examine whether the association between BMI and all-cause mortality varies by sex and age, and, if relevant, to estimate sex-age-specific optimal BMIs associated with a minimal risk of death. Methods: A total of 12 832 637 Korean adults aged 18–99 years who participated in health examinations during 2001–04 were followed up until 2013. Hazard ratios of death in sex-age groups were calculated using Cox regression models after adjustment for age, smoking status and known pre-existing illness. Results: During follow-up, 456 175 men and 241 208 women died. Among men, the age-specific optimal BMI was 23.0–25.9 (kg/m2) at 18–34 years, 24.0–27.9 at 45–54 year, and 25.0–28.9 at 65–74 years. Among women, it was 15.5–24.9 at 18–34 years, 21.0–26.9 at 45–54 years and 24.0–28.9 at 65–74 years. Patterns of sex-age-specific association generally did not differ between never-smokers with no known illness and all participants. Progressively increased risks above and below sex-age-specific optimums were observed (reverse J-curve). Smoking had a limited impact on the observed associations. Conclusions: Women had a lower optimal BMI than men, especially at younger ages. The optimal BMI increased with age. Change in optimal BMI with age, however, was more profound in women than in men. Sex-age-specific optimums were generally higher than the current normal weight (BMI of 18.5–24.9), except in women below 50 years. Sex-age-specific guidelines related to body weight may be needed to guide people for better health.
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            Nutrition management for head and neck cancer patients improves clinical outcome and survival

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              Multicenter, phase 3 trial comparing selenium supplementation with observation in gynecologic radiation oncology.

              We assessed whether adjuvant supplementation with selenium improves the selenium status and reduces side effects of patients treated by radiotherapy (RT) for cervical and uterine cancer. Whole-blood selenium concentrations were measured in patients with cervical cancer (n = 11) and uterine cancer (n = 70) after surgical treatment, during RT, at the end of RT, and 6 weeks after RT. Patients with initial selenium concentrations of less than 84μg/L were randomized before RT either to receive 500 μg of selenium (in the form of sodium selenite [selenase, biosyn Arzneimittel GmbH, Fellbach, Germany]) by mouth on the days of RT and 300 μg of selenium on the days without RT or to receive no supplement during RT. The primary endpoint of this multicenter Phase 3 study was to assess the efficiency of selenium supplementation during RT; the secondary endpoint was to decrease radiation-induced diarrhea and other RT-dependent side effects. A total of 81 patients were randomized. We enrolled 39 in the selenium group (SG) and 42 in the control group (CG). Selenium levels did not differ between the SG and CG upon study initiation but were significantly higher in the SG at the end of RT. The actuarial incidence of diarrhea of Grade 2 or higher according to Common Toxicity Criteria (version 2) in the SG was 20.5% compared with 44.5% in the CG (p = 0.04). Other blood parameters, Eastern Cooperative Oncology Group performance status, and self-reported quality of life were not different between the groups. Selenium supplementation during RT is effective in improving blood selenium status in selenium-deficient cervical and uterine cancer patients and reduces the number of episodes and severity of RT-induced diarrhea. Copyright © 2010 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Trace Elements and Electrolytes
                TE
                Dustri-Verlag Dr. Karl Feistle
                0946-2104
                2019
                October 01 2019
                : 36
                : 10
                : 175-179
                Article
                10.5414/TEX01585
                7ba6c174-4893-4476-8eeb-73fd33fc9ad3
                © 2019
                History

                Endocrinology & Diabetes,General medicine,Medicine,Gastroenterology & Hepatology,Nutrition & Dietetics
                bioimpedance analysis,head and neck cancer,trace elements,malnutrition

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