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Supportive Care in Cancer
Published in: Supportive Care in Cancer 12/2012

01-12-2012 | Original Article

Immunonutrition before and during radiochemotherapy: improvement of inflammatory parameters in head and neck cancer patients

Authors: Christelle Machon, Simon Thezenas, Anne-Marie Dupuy, Eric Assenat, Françoise Michel, Emilie Mas, Pierre Senesse, Jean-Paul Cristol

Published in: Supportive Care in Cancer | Issue 12/2012

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Abstract

Purpose

Inflammatory, angiogenic and oxidative stress markers have been explored in head and neck squamous cell carcinoma (HNSCC) patients before and during radiochemotherapy. Furthermore, the effects of an oral supplementation containing amino acids, ω-3 fatty acids, ribonucleic acids, vitamins, and antioxidants on biological markers and acute toxicities were investigated.

Methods

Thirty-one patients with non-metastatic stage III or IV HNSCC treated with concomitant radiochemotherapy were recruited. A nutritional support (Oral Impact®) was given during 5 days before each cycle of chemotherapy. Biological samples were collected at baseline, after 5 days of oral supplementation and before the last cycle of chemotherapy. Acute phase proteins levels, proteomic cytokines determination and urinary isoprostanes levels were used as inflammatory and oxidative stress biomarkers. Toxicities were followed up during radiochemotherapy.

Results

At baseline, median levels of inflammatory (CRP 9.8 mg/l [0.8–130.1], IL-6 4.2 pg/ml [0.7–126.5]), pro-angiogenic (VEGF 229.5 pg/ml [13.1–595.9]) and pro-oxidative stress (urinary isoprostanes 118 pmol/mmol creatinine [51–299]) markers were increased. Decrease in CRP (p = 0.002) and α-1 acid glycoprotein (p = 0.020) levels were observed after 5 days of oral supplementation. During radiochemotherapy, no significant variation of inflammatory markers was reported, and a low incidence of severe acute mucositis was noted.

Conclusions

Stage III or IV HNSCC patients are characterised by a pro-inflammatory, pro-angiogenic and pro-oxidative status. Nutritional support could improve this inflammatory state and could prevent severe acute mucositis.
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Metadata
Title
Immunonutrition before and during radiochemotherapy: improvement of inflammatory parameters in head and neck cancer patients
Authors
Christelle Machon
Simon Thezenas
Anne-Marie Dupuy
Eric Assenat
Françoise Michel
Emilie Mas
Pierre Senesse
Jean-Paul Cristol
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 12/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-012-1444-5

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