Phase Angle During Paediatric Cancer Treatment: Associations with Complications and Micronutrients in a Multicentre International Prospective Cohort Study.
In a 115-participant international prospective pediatric cancer cohort, phase-angle Z-scores declined during the first six months of treatment, later recovered, and were associated with complication burden and circulating albumin, zinc, and selenium but not anthropometric nutritional categories.
Open original publication →What the AI sees
In a 115-participant international prospective pediatric cancer cohort, phase-angle Z-scores declined during the first six months of treatment, later recovered, and were associated with complication burden and circulating albumin, zinc, and selenium but not anthropometric nutritional categories.
Research significance
The evidence supports phase angle as a candidate longitudinal marker of physiological and body-composition changes during pediatric cancer treatment; it is inferential, but not demonstrated, that phase-angle monitoring could help identify patients needing earlier nutritional assessment or supportive intervention, and no treatment benefit from phase-angle-guided care was tested.
Source abstract
BACKGROUND & AIMS: Phase angle (PhA), derived from bioelectrical impedance analysis, is consistently associated with fat-free mass and cellular integrity and has been widely studied as a prognostic marker in several diseases; however, evidence in paediatric oncology remains limited. This study aimed to describe longitudinal changes in PhA during cancer treatment in children and young people (CYP) and to examine associations with treatment-related complications, nutritional status, and micronutrient biomarkers. METHODS: Data were drawn from two prospective cohort studies conducted in Scotland and New Zealand. CYP (<18 years) undergoing cancer treatment were assessed at baseline and at 3, 6, 9, and 12 months. PhA was measured using single-frequency (50 kHz) bioelectrical impedance analysis, and Z-scores (PhA-Z) were calculated. Treatment-related complications were recorded prospectively, and participants were classified into tertiles according to the cumulative number of complications over 12 months (≤3, >3-≤7, and >7). Nutritional status categories (eutrophic, overweight and obese) were defined through body mass index and mid-upper arm circumference. Circulating plasma biomarkers included albumin; vitamins A, E, and B12; magnesium; selenium; and zinc. Mixed-effects models were used to assess longitudinal changes and associations. RESULTS: A total of 115 participants were included, with baseline PhA-Z data available for 68. PhA-Z declined from baseline to 3 months (B = -0.82, 95% CI -1.32, -0.32) and to 6 months (B = -0.63, 95% CI -1.17, -0.08). Post hoc analyses indicated recovery at 12 months compared with 3 (p = 0.001, effect size [ES] = 0.63, 95% CI: 0.32 to 0.96) and 6 months (p = 0.019, ES = 0.54, 95% CI: 0.22 to 0.86). Compared with the >7 complications group, participants with ≤3 and >3-≤7 complications showed higher estimated PhA-Z at 6 (B = 2.04; 2.30), 9 (B = 2.79; 2.07), and 12 months (B = 2.20; 1.82) (p<0.05). Anthropometric nutritional status classifications were not associated with PhA-Z, while albumin, zinc, and selenium were positively associated. CONCLUSIONS: PhA-Z declined early and recovered later during therapy. Associations with complication burden and selected micronutrients suggest that PhA may be a promising marker of treatment-related alterations in body composition and physiological status, warranting confirmation in larger prospective studies.