Supportive Care in Cancer

, Volume 18, Issue 11, pp 1385–1391

Explorative study on the predictive value of systematic inflammatory and metabolic markers on weight loss in head and neck cancer patients undergoing radiotherapy

  • Ylva Tiblom Ehrsson
  • Per M. Hellström
  • Kerstin Brismar
  • Lena Sharp
  • Ann Langius-Eklöf
  • Göran Laurell
Original Article

DOI: 10.1007/s00520-009-0758-4

Cite this article as:
Ehrsson, Y.T., Hellström, P.M., Brismar, K. et al. Support Care Cancer (2010) 18: 1385. doi:10.1007/s00520-009-0758-4



This study aimed to explore the predictive value of systematic inflammatory and metabolic markers in head and neck (H&N) cancer patients during radiotherapy (RT).


Twenty-seven patients were evaluated. The protocol included serial blood tests [highly sensitive C-reactive protein (hsCRP), albumin, insulin-like growth factor 1 (IGF-1), IGF binding protein 1 (IGFBP-1) and ghrelin], measurements of body weight and assessment of oral mucositis.


The mean nadir of weight loss was observed at the end of RT. At the time of diagnosis, mean hsCRP was 5.2 ± 1.0 mg/L. HsCRP significantly increased during RT and decreased during the post-RT period. Mean maximum hsCRP was 35.8 ± 8.5 mg/L, with seven patients reaching >40 mg/L. A numerical decrease of albumin (by 18.2%) and only small changes in IGF-1, IGFBP-1 and ghrelin levels were observed. None of the metabolic parameters was significantly associated with weight loss.


HsCRP increased in response to RT for H&N cancer as a sign of irradiation-induced inflammation. Weight loss was not preceded by changes of the metabolic parameters, indicating that assessment of the blood markers used in this study is of little value. Regular body weight measurement and assessment of oral mucositis are feasible, cheap and important procedures to control the metabolic homeostasis during RT.


Highly sensitive C-reactive protein Albumin Insulin-like growth factor 1 Insulin-like growth factor binding protein 1 Ghrelin Weight loss 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Ylva Tiblom Ehrsson
    • 1
  • Per M. Hellström
    • 2
  • Kerstin Brismar
    • 3
  • Lena Sharp
    • 4
  • Ann Langius-Eklöf
    • 5
  • Göran Laurell
    • 6
  1. 1.Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
  2. 2.Department of Medical ScienceUppsala University HospitalUppsalaSweden
  3. 3.Department of Molecular Medicine and SurgeryKarolinska InstitutetStockholmSweden
  4. 4.Department of OncologyKarolinska University HospitalStockholmSweden
  5. 5.School of Medical and Health SciencesÖrebro UniversityÖrebroSweden
  6. 6.Department of Clinical SciencesUmeå UniversityUmeåSweden