Cytokines levels, severity of acute mucositis and the need of PEG tube installation during chemo-radiation for head and neck cancer--a prospective pilot study.

Abstract

BACKGROUND:

The purpose of this pilot study was to detect a correlation between serum cytokine levels and severity of mucositis, necessitating installation of a percutaneous endoscopic gastrostomy tube (PEG) in head and neck (H&N) cancer patients receiving combined chemo-radiation therapy.

PATIENTS AND METHODS:

Fifteen patients with H&N epithelial cancer were recruited to this study. All patients received radiotherapy to the H&N region, with doses ranging from 50-70 Gy. Chemotherapy with cisplatin, carboplatin, 5-fluorouracil and taxanes was given to high-risk patients, using standard chemotherapy protocols. Patients were evaluated for mucositis according to WHO common toxicity criteria, and blood samples were drawn for inflammatory (IL-1, IL-6, IL-8, TNF-alpha) and anti-inflammatory (IL-10) cytokine levels before and during treatment.

RESULTS:

A positive correlation was found between IL-6 serum levels and severity of mucositis and dysphagia; specifically, high IL-6 levels at week 2 were correlated with a need for PEG tube installation. A seemingly contradictory correlation was found between low IL-8 serum levels and a need for a PEG tube.

CONCLUSION:

These preliminary results, indicating a correlation between IL-6 and IL-8 serum levels and severity of mucositis and a need for a PEG tube installation, justify a large scale study.

• Authors: Amichay Meirovitz, Michal Kuten, Salem Billan, Roxolyana Abdah-Bortnyak, Anat Sharon, Tamar Peretz, Mordechai Sela, Moshe Schaffer, Vivian Barak
• Journal: Radiation oncology (London, England) (Radiat Oncol) Vol. 5 Pg. 16 (Feb 25 2010) ISSN: 1748-717X [Electronic] England
• PMID: 20184737 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Cytokines

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Combined Modality Therapy
• Cytokines (blood)
• Enteral Nutrition
• Female
• Head and Neck Neoplasms (blood, complications, therapy)
• Humans
• Male
• Middle Aged
• Mucositis (etiology, therapy)
• Neoplasm Staging
• Pilot Projects
• Radiotherapy (adverse effects)
• Young Adult