title: Explorative study on the predictive value of systematic inflammatory and metabolic markers on weight loss in head and neck cancer patients undergoing radiotherapy.
abstract: OBJECTIVE
  This study aimed to explore the predictive value of systematic inflammatory and metabolic markers in head and neck (H&N) cancer patients during radiotherapy (RT).
  
  
  METHODS
  Twenty-seven patients were evaluated. The protocol included serial blood tests [highly sensitive C-reactive protein (hsCRP), albumin, insulin-like growth factor 1 (IGF-1), IGF binding protein 1 (IGFBP-1) and ghrelin], measurements of body weight and assessment of oral mucositis.
  
  
  RESULTS
  The mean nadir of weight loss was observed at the end of RT. At the time of diagnosis, mean hsCRP was 5.2 ± 1.0 mg/L. HsCRP significantly increased during RT and decreased during the post-RT period. Mean maximum hsCRP was 35.8 ± 8.5 mg/L, with seven patients reaching >40 mg/L. A numerical decrease of albumin (by 18.2%) and only small changes in IGF-1, IGFBP-1 and ghrelin levels were observed. None of the metabolic parameters was significantly associated with weight loss.
  
  
  CONCLUSIONS
  HsCRP increased in response to RT for H&N cancer as a sign of irradiation-induced inflammation. Weight loss was not preceded by changes of the metabolic parameters, indicating that assessment of the blood markers used in this study is of little value. Regular body weight measurement and assessment of oral mucositis are feasible, cheap and important procedures to control the metabolic homeostasis during RT.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden. ylvatiblomehrsson@telia.com
authors.forename: Ylva Tiblom
authors.initials: YT
authors.lastname: Ehrsson
authors.forename: Per M
authors.initials: PM
authors.lastname: Hellström
authors.forename: Kerstin
authors.initials: K
authors.lastname: Brismar
authors.forename: Lena
authors.initials: L
authors.lastname: Sharp
authors.forename: Ann
authors.initials: A
authors.lastname: Langius-Eklöf
authors.forename: Göran
authors.initials: G
authors.lastname: Laurell
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011832:Radiation Injuries; D013280:Stomatitis / Q000175:diagnosis* / Q000209:etiology; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein