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.
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.
Meirovitz
Amichay
A
Department of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Kuten
Michal
M
Billan
Salem
S
Abdah-Bortnyak
Roxolyana
R
Sharon
Anat
A
Peretz
Tamar
T
Sela
Mordechai
M
Schaffer
Moshe
M
Barak
Vivian
V
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
D016207:Cytokines