Weakness could be correlated with normal or decreased phase angle in a population with ambulatory advanced cancer with fatigue naive of treatment. We also found a significant relationship between median phase angle score and endurance muscle with percentage of weight loss in the subpopulation of patients with head and neck carcinoma.

In this preliminary study of few patients, we have observed a potential usefulness of Supportan(®) in the compliance of concurrent RT-CHT in patients with H&N cancers; moreover, its administration was useful to maintain the initial biochemical nutritional profile.

The aim of the study was to evaluate the nutritional status of patients suffering from head and neck cancer at the beginning of the specific treatment, through the use of biochemical parameters (1) . Body weight (w, kg) and height (h, m) were determined, and the BMI calculated in 20 adults, who attended TRU, Angel Roffo Institute of Oncology. Blood samples were collected from fasting patients. Specific serum protein fractions of potential usefulness in nutrition studies: transthyretin (TTR), transferrin (Transf), C3 (C3c) and C4 complement (C4c); and acute phase serum fractions: ceruloplasmin (Cp), haptoglobin (Hapto) and protein C reactive (PCR) were measured by single radial immunodiffusion technique on agar gel layers (Biocientífica S.A., Argentina and Binding Site, UK) (2,3) . Clinical aspects were evaluated by Bioelectrical Impedance Analysis (BIA that determines electrical properties of the body resistance (R) and capacitance (Xc)); and basal metabolism (BM). We calculated the phase angle (arc tangent of the ratio Xc to R in degrees) that measures lean body mass (3) . Biochemical parameters (mg/dl), and BMI (kg/m 2 ) expressed as means and SD, were compared with reference values (VR). The data showed lower TTR, C3c and Transferrin together with higher Cp and Haptoglobin sera levels, than reference values. Results pointed out to a depressed nutritional status and inflammation. Besides, only 10 % showed BMI < 18.5 %. Thirty-five percent patients had reduction of phase angle and 15 % had increased of BM with increased PCR. These findings stress the importance of the inclusion of functional biochemical parameters in the periodic nutritional evaluation of these patients. This would allow an early assessment of the need for appropriate nutritional support, since 70 % of patients had normal BM and in this situation patients re-feeding is possible (1,4) ; on the other hand, patients with increased BM and phase angle (30-25 % respectively) could be a subgroup with systemic inflammatory status where re-feeding may not be useful.

Nutritional status depression in persons suffering from head and neck cancer has been scarcely study. An inadequate nutrient intake could be the principal factor (1)(2)(3) . Previous study in a group of patients underwent conventional therapy showed changes in specific serum protein fractions, indicative of an impairment of nutritional status and inflammation (4) . The goal is the evaluation of nutritional status through the use of biochemical parameters in a subgroup of adult patients suffering from head and neck cancer before and after oral intake of a nutritional supplement.The study was performed on seven patients (n = 7, 45-60 years old), who were attended in the Angel Roffo Institute, with local advanced head and neck cancer, underwent therapy with Chemoradiotherapy that completed oral intake of a nutritional supplement, during 60 days (Supportan 1 , Fresenius-Kabi ). The supplement provides 500 Kcal/day, with 27 % of total calories cover by proteins, 40 % by lipids (2 g EPA provided by fish oil, MCT and vegetal oils) and 33 % of carbohydrates. Patients had not severe mucositis -ulcera, bleeding and/or infection. Never of them had another severe toxicity by treatment nor had impairment of Perfomance Status. Blood samples were collected from fasting patients before (To) and after (Tf) the oral administration of the supplement. Specific serum protein fractions of potential usefulness in nutrition studies: transthyretin (TTR), transferrin (Transf), C3 (C3c), and C4 (C4c); acute phase serum fractions: ceruloplasmin (Cp), haptoglobin (Hp) and protein C reactive (PCR) were measured by single radial immunodiffusion technique on agar gel layers (Biocientífica S.A., Argentina and Binding Site, UK). Biochemical parameters (Tf vs To) (mg/dl),expressed as X (SD) were: TTR: 21.1 (8.9) vs 22.9 (7.3); Transf: 188.9 (36.1) vs 207.3 (20.9); C3c:122.6 (24.9) vs 122.5 (52.3); C4c: 37.5 (7.4) vs 38.9 (11.1); Cp: 40.0 (6.7) vs 36.1(11.7), Hp: 334.0 (194.2) vs 245.6 (103.9); PCR: 1.4 (0.3) vs 1.6 (2.1). No differences between Tf and To were observed. These preliminary results suggest that the oral supplement administration was useful to maintain the initial biochemical nutritional profile. As a matter of fact, we consider a probable beneficial tendency in the implementation of this oral supplement to this type of treatment for head and neck carcinoma.

The evaluation of nutritional status, through biochemical parameters, in a subgroup of these patients, before and after oral intake of a nutritional supplement. Seven adult patients, were attended in the A. Roffo Institute, with local advanced head and neck cancer, underwent therapy with chemoradiotherapy that completed oral intake of a nutritional supplement, during 60 days (Supportan®, Fresenius‐Kabi ). The supplement provides 500Kcal/day, P%27, F%40 (2 g EPA provided by fish oil, MCT and vegetal oils) and 33% of carbohydrates. Blood samples were collected from patients before(To) and after (Tf) the oral administration of the supplement plus habitual diet. Specific serum protein fractions:TTR, transferrin, C3c, C4c, Cp, Hp and PCR were measured by single radial immunodiffusion technique(Biocientífica SA, Argentina and Binding Site, UK).ResultsTf vs To (mg/dl), expressed as X (SD) were:TTR:21.1(8.9) vs 22.9(7.3); Transferrin:188.9(36.1) vs 207.3 (20.9) ;C3c :122.6(24.9) vs 122.5(52.3);C4c:37.5( 7.4) vs 38.9 (11.1); Cp: 40.0 (6.7) vs 36.1(11.7), Hp: 334.0(194.2) vs 245.6(103.9); PCR : 1.4( 0.3) vs 1.6(2.1). No differences between Tf and To were observed. Data suggest that the administration of this oral supplement was useful to maintain the initial biochemical nutritional profile. Supported by UBA( 20020100100044)