Prognostic value of bioelectrical impedance analysis in head and neck cancer patients undergoing radiotherapy: a VALOR® study.

Autor:	Prior-Sánchez I; Endocrinology and Nutrition Department, Jaen University Hospital, Jaen, Spain., Herrera-Martínez AD; Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.; Endocrinology and Nutrition Service, Reina Sofia University Hospital, Cordoba, Spain., Zarco-Martín MT; Department of Endocrinology and Nutrition, San Cecilio University Hospital, Granada, Spain.; Granada Biosanitary Research Institute (Ibs. Granada), Granada, Spain., Fernández-Jiménez R; Malaga Biomedical Research Institute and BIONAND Platform, Endocrinology and Nutrition Department, Hospital Virgen de la Victoria de Malaga, Malaga, Spain.; Department of Endocrinology and Nutrition, Quironsalud Malaga Hospital, Malaga, Spain.; Department of Medicine and Dermatology, Malaga University, Malaga, Spain., Gonzalo-Marín M; Endocrinology and Nutrition Department, Malaga Regional University Hospital, Malaga, Spain.; Malaga Biomedical Research Institute and BIONAND Platform, Malaga, Spain., Muñoz-Garach A; Granada Biosanitary Research Institute (Ibs. Granada), Granada, Spain.; Department of Endocrinology and Nutrition, Virgen de las Nieves University Hospital, Granada, Spain.; Network Biomedical Research Center Physiopathology of Obesity and Nutrition (CiberOBN), Carlos III Health Institute, Madrid, Spain., Vilchez-López FJ; Endocrinology and Nutrition Department, Hospital Universitario Puerta del Mar, Cadiz, Spain.; Biomedical Research and Innovation Institute of Cadiz, Cadiz, Spain., Cayón-Blanco M; Biomedical Research and Innovation Institute of Cadiz, Cadiz, Spain.; Endocrinology and Nutrition Department, Hospital Universitario de Jerez de la Frontera, Cadiz, Spain., Villarrubia-Pozo A; Department of Endocrinology and Nutrition, Seville Institute of Biomedicine (IBIS), Virgen del Rocio University Hospital, Seville, Spain., Muñoz-Jiménez C; Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain.; Endocrinology and Nutrition Service, Reina Sofia University Hospital, Cordoba, Spain., Zarco-Rodríguez FP; Department of Endocrinology and Nutrition, Valme University Hospital, Seville, Spain., Rabat-Restrepo JM; Department of Endocrinology and Nutrition, Macarena University Hospital, Seville, Spain., Luengo-Pérez LM; Department of Endocrinology and Nutrition, Badajoz University Hospital, Seville, Spain.; Department of Biomedical Sciences, Universidad de Extremadura, Badajoz, Spain., Boughanem H; Malaga Biomedical Research Institute and BIONAND Platform, Endocrinology and Nutrition Department, Hospital Virgen de la Victoria de Malaga, Malaga, Spain.; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute, Madrid, Spain.; Unidad de Gestión Clinica Medicina Interna, Lipids and Atherosclerosis Unit, Maimonides Institute for Biomedical Research in Córdoba (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Cordoba, Spain., Martínez-Ramírez MJ; Endocrinology and Nutrition Department, Jaen University Hospital, Jaen, Spain., García-Almeida JM; Malaga Biomedical Research Institute and BIONAND Platform, Endocrinology and Nutrition Department, Hospital Virgen de la Victoria de Malaga, Malaga, Spain.; Department of Endocrinology and Nutrition, Quironsalud Malaga Hospital, Malaga, Spain.; Department of Medicine and Dermatology, Malaga University, Malaga, Spain.; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in nutrition [Front Nutr] 2024 Feb 22; Vol. 11, pp. 1335052. Date of Electronic Publication: 2024 Feb 22 (Print Publication: 2024).
DOI:	10.3389/fnut.2024.1335052
Abstrakt:	Introduction: Bioelectrical impedance analysis (BIA) serves as a method to estimate body composition. Parameters such as phase angle (PA), standardized phase angle (SPA), body mass cell (BCM), BCM index (BCMI), and fat-free mass (FFM) might significantly impact the prognosis of head and neck cancer (HNC) patients. The present study aimed to investigate whether bioelectrical parameters can be used to predict survival in the HNC population and establish the optimal cutoff points for predictive accuracy. Methods: A multicenter observational study was performed across 12 tertiary hospitals in Andalusia (a region from the south of Spain). A total of 494 patients diagnosed with HNC between 2020 and 2022 at different stages were included in this study, with a minimum follow-up period of 12 months. The BIA assessment was carried out during the first 2 weeks of radical radiotherapy treatment with chemotherapy or other systemic treatments. A multivariate logistic regression analysis of overall survival, complications, hospital admission, and palliative care and its relationship with BIA nutritional assessment was performed. Results: Significant prognostic factors identified in the multivariable analysis encompassed phase angle (PA), standardized phase angle (SPA), body cell mass (BCM), and BCM index (BCMI). Lower PA and BCM values were significantly associated with adverse clinical outcomes. A BCM threshold above 17 kg/m 2 was the most significant predictor for predicting survival within the overall HNC population. The PA values of <5.1° in male and <4.8° in female patients showed the best predictive potential for mortality. Increased PA (as a continuous variable) demonstrated a significantly reduced risk for mortality (OR, 0.64; 95% CI, 0.43-0.94; p  < 0.05) and a decreased likelihood of hospital admission (OR, 0.75; 95% CI, 0.52-1.07; p  < 0.05). Higher BCM correlated with a lower risk of mortality (OR, 0.88; 95% CI, 0.80-0.96; p  < 0.01) and a diminished probability of hospital admission (OR, 0.91; 95% CI, 0.83-0.99; p  < 0.05). Conclusion: BIA is a crucial tool in the nutritional assessment of HNC patients. BCM and PA are the main bioelectrical parameters used to predict clinical outcomes in this population. Future studies are needed to validate BIA variables in a large cohort to ensure whether early intensification of nutritional treatment would improve survival. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Prior-Sánchez, Herrera-Martínez, Zarco-Martín, Fernández-Jiménez, Gonzalo-Marín, Muñoz-Garach, Vilchez-López, Cayón-Blanco, Villarubia-Pozo, Muñoz-Jiménez, Zarco-Rodríguez, Rabat-Restrepo, Luengo-Pérez, Boughanem, Martínez-Ramírez and García-Almeida.)
Databáze:	MEDLINE
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