Supportive Care in Cancer

, Volume 20, Issue 12, pp 3129–3135 | Cite as

Immunonutrition before and during radiochemotherapy: improvement of inflammatory parameters in head and neck cancer patients

  • Christelle Machon
  • Simon Thezenas
  • Anne-Marie Dupuy
  • Eric Assenat
  • Françoise Michel
  • Emilie Mas
  • Pierre Senesse
  • Jean-Paul Cristol
Original Article

Abstract

Purpose

Inflammatory, angiogenic and oxidative stress markers have been explored in head and neck squamous cell carcinoma (HNSCC) patients before and during radiochemotherapy. Furthermore, the effects of an oral supplementation containing amino acids, ω-3 fatty acids, ribonucleic acids, vitamins, and antioxidants on biological markers and acute toxicities were investigated.

Methods

Thirty-one patients with non-metastatic stage III or IV HNSCC treated with concomitant radiochemotherapy were recruited. A nutritional support (Oral Impact®) was given during 5 days before each cycle of chemotherapy. Biological samples were collected at baseline, after 5 days of oral supplementation and before the last cycle of chemotherapy. Acute phase proteins levels, proteomic cytokines determination and urinary isoprostanes levels were used as inflammatory and oxidative stress biomarkers. Toxicities were followed up during radiochemotherapy.

Results

At baseline, median levels of inflammatory (CRP 9.8 mg/l [0.8–130.1], IL-6 4.2 pg/ml [0.7–126.5]), pro-angiogenic (VEGF 229.5 pg/ml [13.1–595.9]) and pro-oxidative stress (urinary isoprostanes 118 pmol/mmol creatinine [51–299]) markers were increased. Decrease in CRP (p = 0.002) and α-1 acid glycoprotein (p = 0.020) levels were observed after 5 days of oral supplementation. During radiochemotherapy, no significant variation of inflammatory markers was reported, and a low incidence of severe acute mucositis was noted.

Conclusions

Stage III or IV HNSCC patients are characterised by a pro-inflammatory, pro-angiogenic and pro-oxidative status. Nutritional support could improve this inflammatory state and could prevent severe acute mucositis.

Keywords

Head and neck cancer Radiochemotherapy-induced toxicities Inflammation Immunonutrition 

Notes

Acknowledgments

The authors wish to thank M. Delage for her precious help, Biochemistry Lapeyronie’s technicians and Val d’Aurelle Cancer Institute’s dieticians. This work was supported in part by APARD and Novartis Consumer Health.

Conflict of interest

Nutritional support has been generously provided by Novartis France.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Christelle Machon
    • 1
  • Simon Thezenas
    • 2
  • Anne-Marie Dupuy
    • 1
  • Eric Assenat
    • 3
  • Françoise Michel
    • 1
  • Emilie Mas
    • 1
  • Pierre Senesse
    • 3
  • Jean-Paul Cristol
    • 1
  1. 1.Department of BiochemistryLapeyronie HospitalMontpellier Cedex 5France
  2. 2.Biostatistics UnitVal d’Aurelle Cancer InstituteMontpellierFrance
  3. 3.Department of Medical and Digestive OncologyVal d’Aurelle Cancer InstituteMontpellierFrance

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