Value of vitamin D assessment in patients with head and neck squamous cell cancer before treatment

Abstract

Abstract Introduction: The 5-year survival of patients with head and neck squamous cell carcinoma (HNSCC) has not changed dramatically over the last decades despite the use of various therapeutic modalities, including surgery and/or chemoradiation. Thus, new approaches remain necessary to prevent cancer, reduce recurrence, and improve treatment with reduction of its side effects. There is recent evidence that vitamin D promotes cell differentiation and decreases cell proliferation, invasion, angiogenesis, and metastasis. Thus, it has been hypothesized that vitamin D may protect against cancer at multiple sites. Objective: The aim of this study was to evaluate serum level of vitamin D (VD), calcium, and phosphate in patients with HNSCC before treatment as a step in studying its impact on HNSCC development and progression. Type of the study: This prospective study was conducted between March 2013 and October 2014 at Ain Shams University Hospitals, Cairo, Egypt. Patients and methods: The study included 80 participants categorized into two groups. Group A included 50 (36 males and 14 females) patients with various HNSCC sites; their median age was 54.8 ± 12.7 years. Group B included 30 (20 males and 10 females) sex-matched and age-matched healthy volunteers as controls; their mean age was 50.5 ± 12.0 years. Results: The median VD level in group A was 40.35 (31.9–55) and for group B it was 118.75 (55.0–175) (P < 0.001), indicating a significant decrease of VD in group A than in group B. VD deficiency (<37.5 nmol/ml) in group A was 42%, which was significantly more than that in group B, which was only 3%. Conclusion: This study showed that vitamin D deficiency is prominent in patients with head and neck squamous cell carcinoma before treatment than in controls. Although it may expose the patients to increased risk of therapy-related morbidity and poor outcome, it may constitute an inexpensive prophylactic and cost-effective option in the therapeutic armamentarium as a synergistic agent to traditional treatment options.