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Evaluation of the nutritional status and cachexia in patients diagnosed with Head and Neck Squamous Cell Carcinoma treated with chemoradiation with curative intention

Grant number: 14/00172-9
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): August 01, 2014
Effective date (End): January 31, 2015
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Gilberto de Castro Junior
Grantee:Eduardo Furquim Simão
Home Institution: Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira (ICESP). Coordenadoria de Serviços de Saúde (CSS). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Head and neck cancer (HNC) is a group of different malignant neoplasms located in oral cavity, oropharynx, larynx and hypopharynx, being squamous cell the most frequent histological type, associated with tobacco and alcohol exposure, and to papillomavirus infection. Around 75-80% of all HNC patients present with locally advanced disease, staged as III-IV. In these patients, one of the main treatment options is the platin-based concurrent chemoradiation, with long-term disease-free rate of 30%. However, this treatment is associated with a high toxicity. Malnutrition is frequently seen in HNC patients after treatment. Cachexia as a component of this malnutrition, and defined as a muscle wasting with or without reduction of adipose tissue, has an incidence of around 30-55%. Platin-based concurrent chemoradiation is specially linked to reduced food intake and cachexia development. The objectives of this study are: (1) to evaluate the nutritional status and the presence of cachexia and its severity in patients with HNC with no evidence of disease for at least 2 years; (2) to evaluate the performance of Patient-Generated Subjective Global Assessment as a nutrition assessment tool in these patients.It is a cross-sectional and uniinstitutional study. Eligible patients include all those HNC patients treated with platin-based concurrent chemoradiation with curative intention and disease-free for at least 2 years, with no exclusion criteria, as described in the protocol. 151 subjects will be included and will be submitted to medical history and physical examination, body weight assessment, body mass index calculation, grip and pinch strength measurement; fatigue, anorexia, low lean body mass will be verified; biochemical abnormalities will be measured; Patient-Generated Subjective Global Assessment. It is hypothesized that 30-55% of all studied subjects will be diagnosed with cachexia. As cachexia is a frequent complication in HNC patients and it is related to a high rate of morbidity and mortality, in the daily practice, its prompt diagnosis and treatment seems to be important. (AU)

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