title: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Amichay
authors.initials: A
authors.lastname: Meirovitz
authors.forename: Michal
authors.initials: M
authors.lastname: Kuten
authors.forename: Salem
authors.initials: S
authors.lastname: Billan
authors.forename: Roxolyana
authors.initials: R
authors.lastname: Abdah-Bortnyak
authors.forename: Anat
authors.initials: A
authors.lastname: Sharon
authors.forename: Tamar
authors.initials: T
authors.lastname: Peretz
authors.forename: Mordechai
authors.initials: M
authors.lastname: Sela
authors.forename: Moshe
authors.initials: M
authors.lastname: Schaffer
authors.forename: Vivian
authors.initials: V
authors.lastname: Barak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D003131:Combined Modality Therapy; D016207:Cytokines / Q000097:blood; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology / Q000628:therapy*; D009367:Neoplasm Staging; D010865:Pilot Projects; D011878:Radiotherapy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D016207:Cytokines