TY - JOUR
T1 - Resting energy expenditure in head and neck cancer patients before and during radiotherapy
AU - Langius, Jacqueline A. E.
AU - Kruizenga, Hinke M.
AU - Uitdehaag, Bernard M. J.
AU - Langendijk, Johannes A.
AU - Doornaert, Patricia
AU - Leemans, C. Rene
AU - Weijs, Peter J. M.
PY - 2012/8
Y1 - 2012/8
N2 - Background & aims: Weight loss is a frequently observed problem in patients with head and neck cancer (HNC) during radiotherapy. It is still to be assessed whether hypermetabolism is contributing to this problem. The aim of this study was to investigate hypermetabolism before radiotherapy, and changes in resting energy expenditure (REE) in HNC patients during radiotherapy.Methods: REE was measured by indirect calorimetry in 71 patients with HNC before radiotherapy, after 3 and 6 weeks of radiotherapy, and 3 months after radiotherapy. The association between REE and tumour stage, CRP, and prior tumour surgery was analyzed by linear regression analyses. Forty healthy control subjects were one-to-one matched to 40 patients by gender, age and fat free mass (FFM) index to compare REE.Results: Before radiotherapy, REE was not significantly different between patients and controls, neither in absolute values (1568 +/- 247 vs. 1619 +/- 244 kcal/d; p = 0.29), nor after weight-adjustment (22.1 +/- 3.5 vs. 21.5 +/- 3.3 kcal/kg, p = 0.42) or FFM-adjustment (31.5 +/- 4.9 vs. 30.7 +/- 4.5 kcal/kg, p = 0.38). REE was independent of tumour stage, CRP, and prior tumour surgery. REE (kcal/d) decreased during radiotherapy and thereafter by 9% from pre-radiotherapy (p <0.01). Weight and FFM also decreased significantly over time (p <0.001). REE adjusted for FFM decreased in the first 3 weeks of radiotherapy with 4% (B = -1.39 kcal/kg FFM, p <0.01), increased at the end of radiotherapy and decreased again 3 months after radiotherapy (B = -1.31 kcal/kg FFM, p = 0.04).Conclusions: Head and neck cancer patients had normal REE before radiotherapy. During radiotherapy. REE decreased continuously with ongoing weight loss. However, weight loss is not the only explaining factor, since REE expressed per kg FFM showed a much more divergent course which is currently unexplained. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
AB - Background & aims: Weight loss is a frequently observed problem in patients with head and neck cancer (HNC) during radiotherapy. It is still to be assessed whether hypermetabolism is contributing to this problem. The aim of this study was to investigate hypermetabolism before radiotherapy, and changes in resting energy expenditure (REE) in HNC patients during radiotherapy.Methods: REE was measured by indirect calorimetry in 71 patients with HNC before radiotherapy, after 3 and 6 weeks of radiotherapy, and 3 months after radiotherapy. The association between REE and tumour stage, CRP, and prior tumour surgery was analyzed by linear regression analyses. Forty healthy control subjects were one-to-one matched to 40 patients by gender, age and fat free mass (FFM) index to compare REE.Results: Before radiotherapy, REE was not significantly different between patients and controls, neither in absolute values (1568 +/- 247 vs. 1619 +/- 244 kcal/d; p = 0.29), nor after weight-adjustment (22.1 +/- 3.5 vs. 21.5 +/- 3.3 kcal/kg, p = 0.42) or FFM-adjustment (31.5 +/- 4.9 vs. 30.7 +/- 4.5 kcal/kg, p = 0.38). REE was independent of tumour stage, CRP, and prior tumour surgery. REE (kcal/d) decreased during radiotherapy and thereafter by 9% from pre-radiotherapy (p <0.01). Weight and FFM also decreased significantly over time (p <0.001). REE adjusted for FFM decreased in the first 3 weeks of radiotherapy with 4% (B = -1.39 kcal/kg FFM, p <0.01), increased at the end of radiotherapy and decreased again 3 months after radiotherapy (B = -1.31 kcal/kg FFM, p = 0.04).Conclusions: Head and neck cancer patients had normal REE before radiotherapy. During radiotherapy. REE decreased continuously with ongoing weight loss. However, weight loss is not the only explaining factor, since REE expressed per kg FFM showed a much more divergent course which is currently unexplained. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
KW - Resting energy expenditure
KW - Basal metabolism
KW - Cachexia
KW - Weight loss
KW - Head and neck cancer
KW - Radiotherapy
KW - BIOELECTRICAL-IMPEDANCE ANALYSIS
KW - PATIENTS RECEIVING RADIOTHERAPY
KW - LONGITUDINAL DATA-ANALYSIS
KW - CELL LUNG-CANCER
KW - BODY-COMPOSITION
KW - METABOLIC-RATE
KW - PREDICTIVE EQUATIONS
KW - NUTRITIONAL-STATUS
KW - DIETARY-INTAKE
KW - WEIGHT-LOSS
U2 - 10.1016/j.clnu.2011.12.009
DO - 10.1016/j.clnu.2011.12.009
M3 - Article
SN - 0261-5614
VL - 31
SP - 549
EP - 554
JO - Clinical Nutrition
JF - Clinical Nutrition
IS - 4
ER -