Inflammation Status and Body Composition Predict Two-Year Mortality of Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma under Provision of Recommended Energy Intake during Concurrent Chemoradiotherapy

A novel equation synthesis for estimating resting energy expenditure in prostate cancer patients

BACKGROUND

An accurate calculation of energy expenditure (REE) is necessary for estimating energy needs in malign prostate cancer. The purpose of this research was to evaluate the accuracy of the established novel equation for predicting REE in malign and benign prostate patients versus the accuracy of the previously used predictive equations based on REE measured by indirect calorimetry.

METHODS

The study was conducted as a cross-sectional case-control study and between December 2020 and May 2021 with 40 individuals over the age of 40 who applied to the Urology Clinic of Gazi University Faculty of Medicine. Subjects with 41 malign prostate and 42 benign prostate patients were both over the age of 40 (65.3 ± 6.30 years) and recruited for the study. Cosmed-FitMate GS Indirect Calorimetry with Canopyhood (Rome, Italy) was used to measure REE. A full body composition analysis and anthropometric measurements were taken.

CLINICAL TRIAL NUMBER

Not applicable.

RESULTS

Malign prostate group PSA Total and measured REE values (4.93 ± 5.44 ng/ml, 1722.9 ± 272.69 kcal/d, respectively) were statistically significantly higher than benign group (1.76 ± 0.73 ng/ml, 1670.5 ± 266.76 kcal/d, respectively) (p = 0.022). Malign prostate group (MPG) and benign prostate group (BPG) have the highest percentage of the accurate prediction value of Eq. 80.9% (novel equation MPG) and 64.2% (novel equation BPG). The bias of the equations varied from - 36.5% (Barcellos II Equation) to 19.2% (Mifflin-St. Jeor equation) for the malign prostate group and varied from - 41.1% (Barcellos II Equation) to 17.7% (Mifflin-St. Jeor equation) in the benign prostate group. The smallest root mean squared error (RMSE) values in the malign and benign prostate groups were novel equation MPG (149 kcal/d) and novel equation BPG (202 kcal/d). The new specific equation for malign prostate cancer: REE = 3192,258+ (208,326* body weight (WT)) - (20,285* height (HT)) - (187,549* fat free mass (FFM)) - (203,214* fat mass (FM)) + (4,194* prostate specific antigen total (PSAT)). The new specific equation for the benign prostate group is REE = 615,922+ (13,094*WT). Bland-Altman plots reveal an equally random distribution of novel equations in the malign and benign prostate groups.

CONCLUSIONS

Previously established prediction equations for REE may be inconsistent. Utilising the PSAT parameter, we formulated novel energy prediction equations specific to prostate cancer. In any case, the novel predictive equations enable clinicians to estimate REE in people with malign and benign prostate groups with sufficient and most acceptable accuracy.

Pretreatment Glasgow Prognostic Score Correlated with Serum Histidine Level and Three-Year Mortality of Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma and Optimal Performance Status

Few prospective cohort trials have investigted the effect of pretreatment nutritional and inflammatory status on the clinical outcome of patients with cancer and optimal performance status and assessed the interplay between nutrition, inflammation, body composition, and circulating metabolites before treatment. Here, 50 patients with locally advanced head and neck squamous cell carcinoma (LAHNSCC) and Eastern Cooperative Oncology Group performance status (ECOG PS) ≤ 2 were prospectively recruited along with 43 healthy participants. Before concurrent chemoradiotherapy, compared with healthy controls, the cancer group showed lower levels of histidine, leucine, and phenylalanine and had low values in anthropometric and body composition measurements; however, the group displayed higher ornithine levels, more malnutrition, and severe inflammation. Pretreatment advanced Glasgow prognostic score (1 and 2) status was the sole prognostic factor for 3-year mortality rate and was associated with age and serum histidine levels in patients with cancer. Thus, even at the same tumor stage and ECOG PS, patients with LAHNSCC, poor nutrition, and high inflammation severity at baseline may have inferior survival outcomes than those with adequate nutrition and low inflammation severity. Assessment of pretreatment nutritional and inflammatory status should be included in the enrollment criteria in future studies.

Treatment-Interval Changes in Serum Levels of Albumin and Histidine Correlated with Treatment Interruption in Patients with Locally Advanced Head and Neck Squamous Cell Carcinoma Completing Chemoradiotherapy under Recommended Calorie and Protein Provision

We investigated risk factors for treatment interruption (TI) in patients with locally advanced head and neck squamous-cell carcinoma (LAHNSCC) following concurrent chemoradiotherapy (CCRT), under the provision of recommended calorie and protein intake; we also evaluated the associations between clinicopathological variables, calorie and protein supply, nutrition–inflammation biomarkers (NIBs), total body composition change (TBC), and a four-serum-amino-acid metabolite panel (histidine, leucine, ornithine, and phenylalanine) among these patients. Patients with LAHNSCC who completed the entire planned CCRT course and received at least 25 kcal/kg/day and 1 g of protein/kg/day during CCRT were prospectively recruited. Clinicopathological variables, anthropometric data, blood NIBs, CCRT-related factors, TBC data, and metabolite panels before and after treatment were collected; 44 patients with LAHNSCC were enrolled. Nine patients (20.4%) experienced TIs. Patients with TIs experienced greater reductions in hemoglobin, serum levels of albumin, uric acid, histidine, and appendicular skeletal mass, and suffered from more grade 3/4 toxicities than those with no TI. Neither increased daily calorie supply (≥30 kcal/kg/day) nor feeding tube placement was correlated with TI. Multivariate analysis showed that treatment-interval changes in serum albumin and histidine levels, but not treatment toxicity, were independently associated with TI. Thus, changes in serum levels of albumin and histidine over the treatment course could cause TI in patients with LAHNSCC following CCRT.