Relationship between weakness and phase angle in advanced cancer patients with fatigue

Support Care Cancer. 2013 Jun;21(6):1685-90. doi: 10.1007/s00520-012-1714-2. Epub 2013 Jan 16.

Abstract

Objective: This study aims to determine the relationship between weakness and bioimpedance analysis (BIA)-derived phase angle in a population of untreated cancer patients with fatigue.

Methods: We prospectively evaluated 41 treatment-naive cancer patients of several origins that presented with performance status 1-2, weight loss >5% in the last 6 months, and Fatigue Numeral Scale score >4. Weakness was considered a physical component of the multidimensional fatigue syndrome and was evaluated through several parameters utilizing hand grip strength technique by dinamometry. The same assessment was also performed on a healthy control population (n = 20). BIA-derived phase angle was also determined by BIA.

Results: Compared to healthy controls, cancer patients exhibited significant differences in all the parameters: median fatigue was 6 (range 5-9), evaluated maximal strength mean was 27 ± 10.71 vs. 42 ± 10.74 kg (p < 0.0001 for patients vs. control, respectively), and muscle strength difference (max-min muscle strength) was also statistically different (p < 0.0001). We also determined parameter associations within the patient population. We found statistical significant correlations between median phase angle score and endurance muscle with percentage of weight loss (r = 0.43, p = 0.03) for head and neck cancer patients, and in non-small cell lung cancer patients, grip work correlated significantly with normal or decreased phase angle (r = 0.85), p = 0.006 (Spearman Rank Correlation).

Conclusions: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Carcinoma, Non-Small-Cell Lung / complications*
  • Carcinoma, Squamous Cell / complications*
  • Electric Impedance
  • Fatigue / diagnosis*
  • Fatigue / etiology*
  • Fatigue / physiopathology
  • Female
  • Hand Strength / physiology
  • Head and Neck Neoplasms / complications*
  • Healthy Volunteers
  • Humans
  • Lung Neoplasms / complications*
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Prospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Weight Loss