Salivary Cytokine Levels and Oral Mucositis in Head and Neck Cancer Patients Treated With Chemotherapy and Radiation Therapy

详细信息    查看全文

• 作者：Paolo Bossi ; MD^&lowast ; ; ^{Paolo.bossi@istitutotumori.mi.it} ; Cristiana Bergamini ; MD^&lowast ; ; Rosalba Miceli ; PhD^&dagger ; ; Agata Cova ; MLS^&Dagger ; ; Ester Orlandi ; MD^§ ; ; Carlo Resteghini ; MD^&lowast ; ; Laura Locati ; MD^&lowast ; ; Salvatore Alfieri ; MD^&lowast ; ; Martina Imbimbo ; MD^&lowast ; ; Roberta Granata ; MD^&lowast ; ; Luigi Mariani ; PhD^&dagger ; ; Nicola Alessandro Iacovelli ; MD^§ ; ; Veronica Huber ; MD^&Dagger ; ; Anna Cavallo ; MSc^‖ ; Lisa Licitra ; MD^&lowast ; ; Licia Rivoltini ; MD^&Dagger ;
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2016
• 出版时间：1 December 2016
• 年：2016
• 卷：96
• 期：5
• 页码：959-966
• 全文大小：487 K
• 卷排序：96

文摘

We assessed the presence of salivary cytokines, their modulation during chemoradiation therapy (CTRT), and their association with oral mucositis severity in patients with head and neck cancer (HNC).Methods and MaterialsThe present prospective observational study enrolled 55 patients with locally advanced HNC requiring CTRT. We also studied 10 healthy volunteers and 10 patients with other cancers. The salivary levels of 13 cytokines were analyzed. We constructed a cytokine predictive score of oral mucositis severity.ResultsThe baseline salivary cytokine levels were not associated with the severity of treatment-induced oral mucositis. The cytokine levels overall increased during treatment, especially in patients with worse mucositis. In particular, on univariable analysis, an increase of interleukin (IL)-1β (area under the curve [AUC] 0.733; P=.009), IL-6 (AUC 0.746; P=.005), and tumor necrosis factor-α (AUC 0.710; P=.005) at the third week of treatment was significantly associated with the development of severe oral mucositis. On multivariable analysis, the predictive score based on the IL-1β and IL-6 changes from baseline to week 3 was an early strong predictor of higher grade oral mucositis.ConclusionsThe treatment of HNC patients with concurrent CTRT induces a significant increase in the salivary levels of IL-1β, IL-6, and tumor necrosis factor-α, all positively associated with the severity of mucosal toxicity. A greater increase of IL-1β and IL-6 3 weeks after treatment initiation is predictive of worse oral mucositis, representing a potential tool for the early identification of patients at risk.