RESUMO
BACKGROUND: Apart from surgery, the methods of treatment of HNC are radiotherapy (RTH) and/or chemotherapy (CRTH/CHT). One of the most frequent and serious complications of RTH is oral mucositis (OM). There is a strict correlation between the inflammation and the status of hydration. The aim of the study was to evaluate the changes in hydration, occurring in the course of RTH, measured by means of bioelectrical impedance analysis (BIA) and to analyze them in correlation with the intensification of OM in HNC patients. PATIENTS AND METHODS: Data from 49 HNC patients (stages I-IV) were analyzed. All of them were irradiated using IMRT technique with the doses of 50-70 Gy. Oral mucositis (OM) was evaluated according to RTOG/EORTC guidelines. BIA was performed using ImpediMed bioimpedance analysis SFB7 BioImp v1.55. RESULTS: In the fourth week of RTH, 4-5 days before the occurrence of severe OM, it was found that patients with OM grade 3 or higher compared to OM grade 2 or lower had significantly: lower ICW% values (respectively, 53.02% vs 50.72%; p = 0.0047), higher: ECW%: (47.95% vs 46.92%; p = 0.0020), TBW% (respectively, 56.34% vs 51.06%; p = 0.0455), ECW/ICW (respectively, 0.96 vs 0.86; p = 0.0007) and ECW/TBW (respectively, 0.49 vs 0.46, p = 0.0033). CONCLUSION: Our study indicates that HNC patients undergo changes in hydration in the course of RTH. We have also confirmed that the intensification of OM leads to ICW decrease and the increase of ECW, TBW as well as ECW/ICW and ECW/TBW values.
Assuntos
Água Corporal/fisiologia , Impedância Elétrica , Neoplasias de Cabeça e Pescoço/radioterapia , Estado de Hidratação do Organismo , Lesões por Radiação/diagnóstico , Radioterapia/efeitos adversos , Estomatite/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Lesões por Radiação/etiologia , Estomatite/etiologiaRESUMO
The FAO/WHO Codex Alimentarius Commission publishes a Guide to Codex Maximum Limits for Pesticide Residues (1978) which gives both acceptable daily intake (ADI) values and maximum residue limit (MRL) values for many pesticides in raw agricultural commodities (rac's) from crops on which their use is approved. ADI values are determined from animal toxicology data which given a no-observable-effect level (NOEL) and use of a safety factor. Specific MRL values are calculated from the ADI and a food factor (F), which is the decimal fraction of that rac in the assumed typical diet. One of the difficulties with this procedure is that dietary patterns differ substantially between countries. Whatever dietary pattern is assumed in calculation of the MRLs may be inappropriate for that country. Theoretical maximum residue intakes (TMRIs) were calculated from the Codex ADIs and MRLs using F values calculated from the national dietary patterns published separately in Poland and Honduras. The equation is TMRI = sigma MRLi X Fi X D, where D is the daily individual diet weight of rac's in kilograms for the particular country. The TMRI should be lower than the maximum permitted intake (MPI) calculated as MPI = ADI X 60, where the 60 is an arbitrary human body weight in kilograms. The TMRI exceeded the MPI for 16 of 33 pesticides used in Poland and for 10 of 20 used in Honduras. At the extreme, the Polish TMRI/MPI ratio for aldrin--dieldrin is 19.5 and 18.1 for fenithion; nine pesticides had ratios of 4.0 or higher.(ABSTRACT TRUNCATED AT 250 WORDS)