Induction Chemotherapy for Head and Neck Cancer Occur Potentially Free Carnitine Decrease

Background: Carnitine is related to malaise. Cisplatin is a cause of decreased carnitine. The purpose of this study was to elucidate the effects of one course of induction chemotherapy (IC) for head and neck cancer on blood carnitine levels, focusing on FC.Methods: This single-center prospective study investigated 20 patients diagnosed with primary head and neck cancer who underwent IC with cisplatin, docetaxel, and 5-fluorouracil. FC, acylcarnitine (AC), and total carnitine (TC) levels were measured before starting therapy and on Days 7 and 21 after starting IC. In addition, malaise was evaluated before and after therapy using a visual analog scale (VAS).Results: All subjects were men and the most common primary cancer site was the hypopharynx (9 patients). FC levels before starting therapy and on Days 7 and 21 were 47.7±2.2 μM/mL, 56.7±2.2 μM/mL, and 41.1±1.9 μM/mL, respectively. Compared with before the start of therapy, FC had significantly decreased on Day 21 (p=0.007). AC levels before starting therapy and on Days 7 and 21 were 12.5±1.2 μM/mL, 13.6±1.4 μM/mL, and 10.7±0.7 μM/mL, respectively. TC levels before starting therapy and on Days 7 and 21 were 60.2±2.5 μM/mL, 70.2±3.3 μM/mL, and 51.7±2.3 μM/mL, respectively. No significant differences in AC, TC or VAS were seen before the start of therapy and on Day 21. Conclusions: After IC, a latent decrease in FC occurred without any absolute deficiency or subjective malaise. When concurrent chemoradiotherapy is planned following IC, supportive therapy with carnitine supplementation may be appropriate.