Bioelectrical impedance phase angle as indicator and predictor of cachexia in head and neck cancer patients treated with (chemo)radiotherapy

2016 ◽  
Vol 70 (5) ◽  
pp. 602-606 ◽  
Author(s):  
P Stegel ◽  
N R Kozjek ◽  
B A Brumen ◽  
P Strojan
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Phase Angle ◽  
Neck Cancer ◽  
Bioelectrical Impedance

scholarly journals Bioelectrical impedance phase angle as a prognostic indicator of survival in head-and-neck cancer

2016 ◽  
Vol 23 (5) ◽  
pp. 481 ◽  
Author(s):  
M.S. Wladysiuk ◽  
R. Mlak ◽  
K. Morshed ◽  
W. Surtel ◽  
A. Brzozowska ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Phase Angle ◽  
Neck Cancer ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Neck Surgery ◽  
Department Head ◽  
Nutrition Status

Background Phase angle could be an alternative to subjective global assessment for the assessment of nutrition status in patients with head-and-neck cancer.Methods We prospectively evaluated a cohort of 75 stage iiib and iv head-and-neck patients treated at the Otolaryngology Department, Head and Neck Surgery, Medical University of Lublin, Poland. Bioelectrical impedance analysis was performed in all patients using an analyzer that operated at 50 kHz. The phase angle was calculated as reactance divided by resistance (Xc/R) and expressed in degrees. The Kaplan–Meier method was used to calculate survival.Results Median overall survival in the cohort was 32.0 months. At the time of analysis, 47 deaths had been recorded in the cohort (62.7%). The risk of shortened overall survival was significantly higher in patients whose phase angle was less than 4.733 degrees than in the remaining patients (19.6 months vs. 45 months, p = 0.0489; chi-square: 3.88; hazard ratio: 1.8856; 95% confidence interval: 1.0031 to 3.5446).Conclusions Phase angle might be prognostic of survival in patients with advanced head-and-neck cancer. Further investigation in a larger population is required to confirm our results.

scholarly journals Prospective metrological validation of multifrequency bioelectrical impedance analysis against volumetric imaging to identify sarcopenia in head and neck cancer patients undergoing radiation therapy

2019 ◽  
Author(s):  
Aaron J. Grossberg ◽  
Crosby D. Rock ◽  
Jared Edwards ◽  
Abdallah S.R. Mohamed ◽  
Debra Ruzensky ◽  
...  
Keyword(s):  
Body Composition ◽  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Body Mass ◽  
Neck Cancer ◽  
Bioelectrical Impedance Analysis ◽  
Bioelectrical Impedance ◽  
Impedance Analysis

AbstractImportanceDepleted skeletal muscle mass (sarcopenia) is associated with decreased survival and cancer control in head and neck cancer patients treated with radiotherapy. There is a need for validated measures of body composition that can be implemented in routine clinical workflow.ObjectiveTo validate the use of bioelectrical impedance analysis (BIA) for body composition analysis and diagnosis of sarcopenia in head and neck cancer patients.DesignIn this prospective observational cohort study, baseline 50 patients with head and neck cancer undergoing radiation therapy (RT) were enrolled between February 2016 and March 2017. Baseline BIA measures of skeletal muscle (SM) mass, fat-free mass (FMM), and fat mass (FM) were compared to CT-based estimates of body composition using linear regression. Sex-specific BIA-derived thresholds for sarcopenia were defined by the maximum Youden Index on receiver operator characteristic (ROC) curves of BIA against CT-defined sarcopenia. Changes in body composition across treatment were compared against changes in body weight using linear regression.ParticipantsIn total, 50 patients with pathologically confirmed stage I to IVB non-metastatic head and neck cancer treated with definitive radiation therapy were enrolled.SettingSingle academic referral center.Main Outcome and MeasureThe primary outcome was relative agreement between baseline lean body mass and fat body mass predicted from BIA measurement and CT imaging.ResultsOf the 48 evaluable patients 16 (33.3%) were sarcopenic at baseline based on CT analysis. BIA measures of body composition were strongly correlated with CT measures: SM mass (r = 0.97; R2 = 0.94; p < 0.0001), FFM (r = 0.97; R2 = 0.94; p < 0.0001) and FM (r = 0.95; R2 = 0.90; p < 0.0001). Relationship with normalized indices of SM mass, FFM, and FM was similar between BIA and CT, but not BIA and body mass index (BMI). Patients lost a mean of 5.7 ± 5.8 kg during treatment, of which 1.5 ± 1.9 kg was SM, 2.6 ± 3.3 kg was FFM, and 2.2 ± 2.6 kg was FM. Eight additional patients developed sarcopenia by the end of RT.ConclusionsBIA provides accurate estimates of body composition in head and neck cancer patients. Implementation of BIA in clinical practice may identify patients with sarcopenia.Trial RegistrationClinicalTrials.gov identifier: NCT02615275

scholarly journals A bioimpedance analysis of head-and-neck cancer patients undergoing radiotherapy

2018 ◽  
Vol 25 (3) ◽  
pp. 193 ◽  
Author(s):  
K. Kohli ◽  
R. Corns ◽  
K. Vinnakota ◽  
P. Steiner ◽  
C. Elith ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Water Content ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Membrane Integrity ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Intracellular Water ◽  
Cell Membrane Integrity

Malnutrition is a frequent manifestation in patients with head-and-neck cancer undergoing radiation therapy and a major contributor to morbidity and mortality. Thus, body composition is an important component of an overall evaluation of nutrition in cancer patients. Malnutrition is characterized by weight loss, loss of muscle mass, changes in cell membrane integrity, and alterations in fluid balance. Bioelectrical impedance analysis is a method to analyze body composition and includes parameters such as intracellular water content, extracellular water content, and cell membrane integrity in the form of a phase angle (Φ). Bioelectrical impedance analysis has consistently been shown to have prognostic value with respect to mortality and morbidity in patients undergoing chemotherapy. The goal of the present study was to evaluate the relationship between Φ, time, intracellular water content, and weight for head-and-neck cancer patients undergoing radiotherapy. The results demonstrate that Φ decreases with time and increases with intracellular water content and weight.

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