| Summary: | 碩士 === 台南科技大學 === 生活應用科學研究所 === 98 === Nutrition has been associated to a certain degree with pathogenesis of cancers。Cancer-related malnutrition is multifactorial and has a negative prognosis。Malnutrition in cancer is associated with lower quality of life and lower life expectancy，regardless of cancer stage。Nutritional support is often indicated。Nutritional support should be evaluated primarily by improved clinical outcome。When giving nutritional support, especially artificial nutrition (enteral and parenteral nutrition)，monitoring by secondary parameters， such as biochemical biomarkers is of paramount importance，in order to avoid iatrogenic complications。
Malnutrition in patients with cancers usually came with specific pathologic mechanism；the ubiquitous presence of systemic inflammatory response was the central context of the pathophysiology of cancer。Acute phase protein response (APPR) is characterized by lowered serum concentrations of several serum proteins such as albumin and transferrin secondary to decreased synthesis and/or altered distribution， while serum concentrations of CRP increase due to increased synthesis。Hence，the most important biochemical index measurement in malignant disease is the assessment of systemic inflammatory response, preferably by high-resolution CRP。If normal， common biochemical indices such as albumin, transferrin might be used to monitor nutrition support in malignant disease。
In patients with malnutrition, those two serum proteins decreased。However, researches dealing with the relationship between nutritional biochemical indices and cancers survival remained few。This prospective cohort study determined the relationship between head and neck cancers survival and biochemical indices, albumin and transferrin。From January 2003 to April 2004，82 patients who received with chemotherapy and radiotherapy for head and neck cancers engaged this study。Serum levels of albumin and transferrin were checked before and during the treatment。The primary end point was overall 3-years survival (OS) and secondary end point was disease free 3-years survival (DFS)。Results of this study revealed that pretreatment and post-treatment serum transferrin were positively correlated with 3-years disease free survival(DFS) (p=0.009 & =0.020)；pretreatment serum albumin was positively correlated with 3-years disease free survival(DFS) (p=0.045) and 3-years overall survival (OS) (p=0.000)。
Conclusion：survival for patients who received with chemotherapy and radiotherapy for head and neck cancers was positively correlated with biochemical indices, albumin and transferrin。Although those two indices may not reflect solely the nutrition status for those patients，and nutrition supplement may not increase serum level of albumin and transferrin；those two indices may well reveal the disease status and serve as prognostic indicators for patients with head and neck cancers。
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