The selenium levels and its relation with treatment response in patients with locally advanced lung, head and neck and cervix cancer treated with radical radiotherapy

Öz

OBJECTIVES To evaluate the preradiotherapy selenium levels, the factors affecting these levels and its relation with the treatment response in locally advanced lung, head and neck and cervix carcinoma. METHODS Patient characteristics, preradiotherapy selenium levels and treatment response were evaluated in 33 patients who were treated with radical radiotherapy. Serum selenium level was analyzed and measured by using Perkin Elmer Atomic Absorption Spectrometer and hydrur system. Treatment response was assessed according to World Health Organization criteria. RESULTS Median age was 57 (range: 37-80 years). Twenty-three patients (69.7%) were male and ten patients (30.3%) were female. Eighteen patients (54.5%) had lung cancer, 8 patients had (24.2%) head and neck cancer and 7 patients (21.2%) had cervix carcinoma. Preradiotherapy mean selenium level was found to be 102.2 µg/L (range: 53-141 µg/L). The selenium level was also significantly low in patients with low KPS and low Hb level (p=0.04, p=0.00, respectively). When the relation between the selenium level and tumor response was evaluated it was found that as the selenium levels increased response to treatment also increased (p=0.02). CONCLUSION In the present study it was concluded that low selenium levels affected the treatment response unfavorably and selenium levels were found to be associated with KPS status and Hb levels.

Anahtar Kelimeler

• Radiotherapy,Selenium,Lung Neoplasms,Head and Neck Neoplasms,Uterine Cervical Neoplasms,Spectrophotometry, Atomic

Radikal radyoterapi uygulanan lokal ileri evre akciğer, baş-boyun ve serviks kanserlerinde serum selenyum düzeyi ve tedaviye yanıt ile ilişkisi

Öz

AMAÇ Lokal ileri akciğer, baş-boyun ve serviks karsinomlu olgularda radyoterapi öncesi selenyum düzeyini etkileyen faktörleri ve tedaviye yanıt ile ilişkisinin araştırılmasıdır. GEREÇ VE YÖNTEM Radikal radyoterapi uygulanan 33 olgunun genel özellikleri, tedavi öncesi selenyum düzeyleri ve tedavi yanıtı değerlendirildi. Selenyum ölçümü Perkin Elmer marka Atomik Absorbsiyon Spektrometresi (AAS) ve hidrür sistem kullanılarak yapıldı. Tedavi yanıtı Dünya Sağlık Örgütü kriterlerine göre değerlendirildi. BULGULAR Medyan yaşı 57 (aralık: 37-80) olan, 18 (%54.5) akciğer, 8 (%24.2) baş-boyun, 7 (%21.2) serviks karsinomlu olgunun 23'ü erkek (%69.7), 10'u kadındı (%30.3). Radyoterapi öncesi ortalama selenyum düzeyleri 102.2 µg/L (aralık: 53-141 µg/L) olarak bulundu, KPS ve Hb değeri düşüklüğü olan olgularda selenyum seviyesi de düşük bulundu (sırasıyla p=0.04, p=0.00). Tümör yanıtı ile selenyum seviyesi arasındaki ilişki değerlendirildiğinde, selenyum seviyesi yükseldikçe tedaviye yanıtın arttığı saptandı (p=0.02). SONUÇ Çalışmamızda selenyum düzeyinin düşüklüğünün tedaviye yanıtı kötü yönde etkilediği, selenyum düzeyinin Hb ve KPS ile ilişkili olduğu bulundu.

Anahtar Kelimeler

• Selenyum, kanser, radyoterapi

Kaynakça

1. 1. Soll D. Genetic code: enter a new amino acid. Nature 1988;331(6158):662-3.
2. 2. Rayman MP. The importance of selenium to human health. Lancet 2000;356(9225):233-41.
3. 3. Hardy G, Hardy I. Selenium: the Se-XY nutraceutical. Nutrition 2004;20(6):590-3.
4. 4. Shamberger RJ, Frost DV. Possible protective effect of selenium against human cancer. Can Med Assoc J 1969;100(14):682.
5. 5. Shamberger RJ, Willis CE. Selenium distribution and human cancer mortality. CRC Crit Rev Clin Lab Sci 1971;2(2):211-21.
6. 6. Clark LC, Cantor KP, Allaway WH. Selenium in forage crops and cancer mortality in U.S. counties. Arch Environ Health 1991;46(1):37-42.
7. 7. Schrauzer GN, White DA, Schneider CJ. Cancer mortality correlation studies--III: statistical associations with dietary selenium intakes. Bioinorg Chem 1977;7(1):23-31.
8. 8. Yadav SP, Gera A, Singh I, Chanda R. Serum selenium levels in patients with head and neck cancer. J Otolaryngol 2002;31(4):216-9.

9. 9. Seifried HE, McDonald SS, Anderson DE, Greenwald P, Milner JA. The antioxidant conundrum in cancer. Cancer Res 2003;63(15):4295-8.
10. 10. Lesperance ML, Olivotto IA, Forde N, Zhao Y, Speers C, Foster H, et al. Mega-dose vitamins and minerals in the treatment of non-metastatic breast cancer: an historical cohort study. Breast Cancer Res Tr e a t 2002;76(2):137-43.
11. 11. World Health Organization. WHO handbook for reporting results of cancer treatment. Geneva (Switzerland): World Health Organization; 1979. p. 48.
12. 12. Willett WC, Polk BF, Morris JS, Stampfer MJ, Pressel S, Rosner B, et al. Prediagnostic serum selenium and risk of cancer. Lancet 1983;2(8342):130-4.
13. 13. Ujiie S, Kikuchi H. The relation between serum selenium value and cancer in Miyagi, Japan: 5-year follow up study. Tohoku J Exp Med 2002;196(3):99-109.
14. 14. Kafai MR, Ganji V. Sex, age, geographical location, smoking, and alcohol consumption influence serum selenium concentrations in the USA: third National Health and Nutrition Examination Survey, 1988-1994. J Trace Elem Med Biol 2003;17(1):13-8.
15. 15. Lopes PA, Santos MC, Vicente L, Rodrigues MO, Pavao ML, Neve J, et al. Trace element status (Se, Cu, Zn) in healthy Portuguese subjects of Lisbon population: a reference study. Biol Trace Elem Res 2004;101(1):1-17.
16. 16. Westin T, Ahlbom E, Johansson E, Sandstrom B, Karlberg I, Edstrom S. Circulating levels of selenium and zinc in relation to nutritional status in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 1989;115(9):1079-82.
17. 17. Lajtman Z, Nosso D, Romic Z, Trutin-Ostovic K, Krpan D. Laryngeal cancer and blood selenium levels. Eur Arch Otorhinolaryngol 1994;251(3):170-2.
18. 18. Lajtman Z, Romic Z, Trutin-Ostovic K, Krpan D, Car Z. Nasopharyngeal cancer and blood selenium level. Acta Med Croatica 1994;48(2):73-6.
19. 19. Navarro-Alarcon M, de la Serrana HL, Perez-Valero V, Lopez-Martinez C. Serum selenium levels as indicators of body status in cancer patients and their relationship with other nutritional and biochemical markers. Sci Total Environ 1998;212(2-3):195-202.
20. 20. Last KW, Cornelius V, Delves T, Sieniawska C, Fitzgibbon J, Norton A, et al. Presentation serum selenium predicts for overall survival, dose delivery, and first treatment response in aggressive non-Hodgkin's lymphoma. J Clin Oncol 2003;21(12):2335-41.
21. 21. Hu Y. Studies on the correlation of blood selenium and lung cancer. II. An analysis of serum selenium levels and influencing factors in patients with lung cancer. [Article in Chinese] Zhonghua Liu Xing Bing Xue Za Zhi 1993;14(6):346-9. [Abstract]
22. 22. Psathakis D, Wedemeyer N, Oevermann E, Krug F, Siegers CP, Bruch HP. Blood selenium and glutathione peroxidase status in patients with colorectal cancer. Dis Colon Rectum 1998;41(3):328-35.