Department of Oncology, Clinical Sciences, Lund University
Abstract
The purpose of this study was to investigate how total body protein and its fraction of body weight (body protein fraction) change in cancer patients during different anti-tumor treatments, and to see if these changes have any clinical significance in the form of prognostic value or correlation with disease course and tumor response. In 84 patients, 28 with lung cancer, 24 with gastrointestinal tumors, 30 with breast cancer, 1 with non-Hodgkin lymphoma and 1 with kidney cancer, the total amount of body nitrogen was measured using an in vivo prompt gamma neutron activation technique. Using the relationship 1 g nitrogen to 6.25 g protein, the amount of total body protein was calculated. The measurements of body protein and body weight were made during the period of radiation, cytostatic or hormone treatment. Each patient was his or her own control. The precision of the method for measurement of body protein was ±5% (1 SD). In patients with lung cancer, we noted a significant correlation between changes in total body protein during radiotherapy and the recurrence-free interval and overall survival. Patients, in whom body protein decreased, had a significantly shorter time to tumor recurrence than those in whom body protein increased or remained constant. In patients with gastrointestinal tumors we noted a significant difference between the changes in body protein fraction in the patients with loco-regional disease and the patients with metastasized disease, in whom the changes were greatest. Finally, in patients with metastasized breast cancer there was no significant correlation between change in body protein fraction and tumor response. The conclusions are that the amount of body protein in cancer patients changes during the disease and anti-tumor treatment. The amount of body protein in patients with lung cancer has a prognostic value, as a decrease of body protein is an indicator of tumor invasion and early metastasis as well as a decreased overall survival. In patients with gastrointestinal tumors a correlation between change in body protein fraction and course of the disease was seen