High-dose-rate brachytherapy proved to be an effective treatment modality in locoregional recurrent head and neck cancer. In cases with persistent or residual tumor after primary radiochemotherapy a local boost with brachytherapy can improve the chance of cure of tumor disease.
Objective: Is there a relation between nutritional status and the prognosis of head and neck cancer patients? Which diagnostic procedures gives us sufficient information about the malnutrition of the individual? Material and methods: A first retrospective study analyzes the outeome of 110 patients in relation to initial weight loss and weight loss at the end of radiotherapy. A second study investigated the changing bioimpedance (BIA) data of 27 survivors and 39 patients who died between their first and last measurement during nutritional therapy (at least 4 weeks). Results: A critical initial weight loss is 10 kg or more at the point of diagnosis. At the end of radiotherapy the body mass reduction should be lower than 15 kg. Raw data of BIA reflects the changing nutritional status at the end of life. We observed a stabilized phase angle in survivors (4.7° to 5.2°) whereas dying patients have shown a significant decreased phase angle (4.6° to 3.7°, p < 0.05). Conclusion: The prognosis of head and neck cancer patients is tightly related to their nutritional status. Specific nutritional anamnesis (initial weight loss, total weight loss, BMI) and additional biophysical measurements are recommended to observe the individual status during the follow up.
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