Does polychemotherapy with 5-fluorouracil, methotrexate, and L-folinic acid influence the selenium, zinc, and copper serum levels in cancer of digestive tract?

This study was designed to evaluate selenium, copper, and zinc serum concen tration in patients with cancer of the digestive tract before and after tre atment with 5-fluorouracil. methotrexate, and L-folinic acid. Also, we eval uated whether any change was correlated with the nutritional status of the patients. Tract elements were measured by atomic absorption spectroscopy. T he nutritional status of each patient was assessed through a combination of biohumoral (prealbumin. cholinesterase, cholesterol, transferrin, tot1 pro teins, albumin/ globulin ratio, C-reactive protein) and bio-impedance (perc ent free fat mass, percent fat mass. FFM/FM, percent total body water, extr a/intracellular water. Na+/K+ ratio exchange able, body mass index, basal m etabolic rate, and phase angle) parameters before and after the chemotherap eutic treatment. Most patients showed significant alteration of the nutriti onal parameters compared with control (prealbumin, cholinesterase. percent for fat mass, percent fat mass, P < 0.01 versus controls: cholesterol, tran sferrin P < 0.05 versus controls: total proteins, albumin/globulin ratio P < 0.001 versus controls). However, no significant change of biochemical and bio-impedance parameters was observed at the end of the therapy. Only 4 of the 50 patients showed significant alteration of nutritional indexes after chemotherapy. Selenium and zinc concentration were significantly lower (Se 56.4 +/- 8.4 <mu>g/dL and Zn 79.5 +/- 8.6 mug/dL: P < 0.01, versus control s) whereas copper concentration wax significantly higher (Cu 111.9 +/- 19 < mu>g/dL; P < 0.01) in cancer patients than in control subjects. Moreover, a t the end of treatment selenium and zinc serum levels showed a significant decrease compared with base line values (Se 51.4 +/- 7.2 <mu>g/dL and Zn 73 .4 +/- 7.4 mug/dL; P < 0.001). Copper concentration at the end of the thera py was higher compared with base line concentration (118.4 +/- <mu>g/dL; P < 0.001). The change in tract element serum concentration at the end of the rapy was of the same magnitude in patients who did not show significant cha nge in their nutritional status and in those who did. In conclusion, cancer patients show an alteration in the serum concentration of trace elements. Chemotherapy did not alter the nutritional status of our patients but furth er modified selenium, zinc, and copper serum levels. This suggests that the alteration of trace elements after polychemotherapy is the consequence of a direct effect of antineoplastic drug on the catabolism of trace elements. J. Trace Elem. Exp. Med. 14:73-79, 2001. (C) 2001 Wiley-Liss, Inc.