Bioelectrical impedance phase angle as indicator and predictor of cachexia in head and neck cancer patients treated with (chemo)radiotherapy

Stegel, P; Kozjek, Nada Rotovnik; Brumen, B. Avramovic; Strojan, Primož

doi:10.1038/ejcn.2016.13

Cited by 29 publications

(18 citation statements)

References 29 publications

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“…Based on the results achieved from the studies on patients with HNC, a low value of PA is currently considered an unfavorable factor affecting a patient's nutritional status and survival. This (24). We noted a similar tendency in our study, PA failed to predict malnutrition defined by loss of 5% body mass (AUC=0.585, p=0.352).…”

Section: Discussionsupporting

confidence: 90%

Phase Angle as an Objective and Predictive Factor of Radiotherapy-induced Changes in Body Composition of Male Patients With Head and Neck Cancer

Małecka‐Massalska¹,

Powrózek²,

Prendecka³

et al. 2019

In Vivo

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Background: Unfavorable changes in body composition are frequent among patients with head and neck cancer (HNC). Unfortunately, in daily clinical practice, there is a lack of reliable diagnostic tools for predicting changes in body composition in individuals following radiotherapy (RT). Among non-invasive tools, bioelectrical impedance analysis (BIA) seems to be most promising. One BIA parameter, the phase angle (PA), reflects condition of various body cells and their mass in detail. Materials and Methods: Using BIA, the body composition was measured prior to and after RT in 52 male patients with HNC. PA derived from BIA prior to RT was tested as a predictor of body composition changes developing during RT. Results: Patients with low PA had a greater than 9.3-fold higher chance of body mass index (BMI) reduction below 18.5 kg/m 2 and over 5.9-fold and 4.2-fold higher chance of lean mass and fat mass reduction after therapy end compared with patients with a high PA value. PA values demonstrated significant diagnostic accuracy for detection of fat-free mass, lean mass and BMI reduction in the study group [area under the curve (AUC)=0.781, 0.774 and 0.786, respectively]. Conclusion: PA prior to RT is a useful marker for selection of individuals with HNC who are at a high risk of unfavorable changes in body composition.

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Section: Discussionsupporting

confidence: 90%

Phase Angle as an Objective and Predictive Factor of Radiotherapy-induced Changes in Body Composition of Male Patients With Head and Neck Cancer

Małecka‐Massalska¹,

Powrózek²,

Prendecka³

et al. 2019

In Vivo

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“…Moreover, low PA values affected almost 2-fold higher risk (P = .02) of both malnutrition and cachexia in patients with HNC. 20 Paixão et al found the progressive decrease in PA values during the course of RTH in patients with HNC. PA reduction was parallel with the decrease in body weight (0.107 of PA value on the loss of 1 kg of body mass).…”

Section: Discussionmentioning

confidence: 96%

Combined analysis of miRNA‐181a with phase angle derived from bioelectrical impedance predicts radiotherapy‐induced changes in body composition and survival of male patients with head and neck cancer

et al. 2019

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Background Nutritional deficits developing as an effect of applied radiotherapy (RTH) negatively affect patients' quality of life, survival, and therapy outcomes. We demonstrated novel approach to prediction of RTH‐induced changes in body composition of patients with head and neck cancer using phase angle (PA) derived from bioelectrical impedance in combination with miRNA‐181a expression. Results Patients with simultaneous presence of low PA and high miRNA expression were at a significantly higher risk of decreasing the fat‐free mass index (FFMI) <14.9 kg/m2 (odds ratio [OR] = 5.14; P = .02), FFM < 44.7 kg (OR = 6.20; P = .04), and lean mass (OR = 10.0; P = .04) during the therapy period. Receiver operating curve analysis allowed to predict changes in FFMI, lean mass, and FFM with area under the curve calculation over 0.700. The simultaneous presence of high miRNA and low PA negatively affected patients' survival (OR = 5.12; P = .02). Conclusion Evaluation of PA in combination with miRNA demonstrates higher diagnostic accuracy and predictive value for detecting RTH‐induced changes in body composition of patients with cancer.

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“…Cachectic patients were identified using the international consensus criteria, with a simple starvation excluded by the presence of three out of five criteria: decreased muscle strength, low fat-free mass index (FFMI, < 14.6 kg/m 2 ), anorexia, fatigue, and abnormal biochemistry indicating inflammation, anemia or hypoalbuminemia [17,18]. For this purpose, a body mass index (BMI) was calculated (weight/height 2 [kg/ m 2 ]) and the hand-grip strength was measured with Jamar ® Hand Dynamometer (Warrenville, IL, USA) as described elsewhere [19]. A fifth percentile normative grip strength values stratified by age and gender were used to determine decreased muscle strength [20].…”

Section: Study Design and Investigationsmentioning

confidence: 99%

Psychological distress and nutritional status in head and neck cancer patients: a pilot study

Gosak

Gradišar

Kozjek

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose To determine whether the psychological state of patients with head and neck cancer (HCN) is associated with their nutritional status. Methods In 40 patients with locally advanced HNC treated with definitive or adjuvant (chemo)radiotherapy, psychological and nutritional status were assessed before treatment, at its completion and 3 months' post-therapy. Psychosocial distress was measured using the Hospital Anxiety and Depression Scale questionnaire (HADS-A, HADS-D), whereas the nutritional status was evaluated using standard methods (Nutritional Risk Screening Tool 2002, anthropometric data, dynamometry and laboratory tests) and with a bioelectrical impedance analysis parameter phase angle (PA). Results Before treatment, more patients were screened positive for anxiety than at treatment completion (p = 0.037) or 3 months' post-therapy (p = 0.083). Depression prevalence was non-significantly higher at the end and after therapy. Compared to the baseline, more cachectic patients and a reduction of PA values were found at successive assessments. Anxiety was more often recorded among malnourished/cachectic patients (assessment 1, p = 0.017; assessment 2, p = 0.020) who were also found more frequently depressed (assessment 2, p = 0.045; assessment 3, p = 0.023). Significantly higher PA values were measured in patients without distress determined at 3 months' post-therapy by the HADS-A (p = 0.027). Conclusion The association between the psychological and nutritional status found in this pilot study and the options for intervention warrants further clarification in a larger prospective trial.

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Bioelectrical impedance phase angle as indicator and predictor of cachexia in head and neck cancer patients treated with (chemo)radiotherapy

Abstract: PA did not distinguish between malnourished and cachectic patients with HNSCC, and pre-treatment PA did not predict cachexia development during (chemo)radiation. Nevertheless, PA seems to be a good marker of nutritional status in HNSCC patients.

Cited by 29 publications

References 29 publications

Phase Angle as an Objective and Predictive Factor of Radiotherapy-induced Changes in Body Composition of Male Patients With Head and Neck Cancer

Phase Angle as an Objective and Predictive Factor of Radiotherapy-induced Changes in Body Composition of Male Patients With Head and Neck Cancer

Combined analysis of miRNA‐181a with phase angle derived from bioelectrical impedance predicts radiotherapy‐induced changes in body composition and survival of male patients with head and neck cancer

Psychological distress and nutritional status in head and neck cancer patients: a pilot study

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