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Systemic Inflammatory Reaction in Patients With Head and Neck Cancer-An Explorative Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.ORCID iD: 0000-0001-6006-9665
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology. Uppsala Univ, Dept Immunol Genet & Pathol, Uppsala, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.ORCID iD: 0000-0001-8623-0939
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.ORCID iD: 0000-0001-7435-167x
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2019 (English)In: Frontiers in Oncology, ISSN 2234-943X, E-ISSN 2234-943X, Vol. 9, article id 1177Article in journal (Refereed) Published
Abstract [en]

Aim: To assess the longitudinal pattern of pro-inflammatory cytokines and growth factors in serum up to 1 year following treatment for head and neck cancer. Materials and Methods: Patients with newly diagnosed, curable head and neck cancer were included (n = 30). The most common subsite was oropharynx (n = 13) followed by oral cavity (n = 9). Blood was drawn from all patients at regular intervals (before treatment, 7 weeks after the start of the treatment, and at 3 months and 1 year after termination of treatment) and analyzed for cytokines (Il-1 beta, Il-2, Il-4, Il-5, Il-6, Il-8, Il-10, GM-CSF, TNF-alpha, and IFN-gamma) and growth factors (G-CSF, FGF-2, EGF, and VEGF). Results: The time point of the peak level of pro-inflammatory cytokines was 7 weeks after start of treatment which corresponded for the majority of patients with termination of radiotherapy or chemoradiotherapy. Patients undergoing chemoradiotherapy exhibited a significant increase of IL-1 beta, IL-6, and IL-10 at 7 weeks as compared to pre-treatment levels. At 1 year after termination of treatment four patients experienced recurrence of disease while 26 patients were considered disease-free. The patients with recurrence had significantly higher levels of IL-1 beta, IL-6, IL-8, and IL-10 at 7 weeks after the start of treatment than patients without recurrence. Correlated with T stadium patients with T3-T4 had higher levels of IL-1 beta and IL-8 than patients with T1-T2 7 weeks after the start of treatment. Conclusions: The observed immune response in this explorative study demonstrates that chemoradiotherapy may induce not only a local treatment effect on the immune system but also effects far outside the irradiated field. The result of the study indicates that analysis of a pro-inflammatory panel of cytokines in serum at 7 weeks after the start of treatment could be of prognostic value in patients with head and neck cancer. Further study of a larger cohort could help identify patients at larger risk for recurrent disease with measurements of pro-inflammatory cytokines under and after treatment.

Place, publisher, year, edition, pages
FRONTIERS MEDIA SA , 2019. Vol. 9, article id 1177
Keywords [en]
radiotherapy, chemoradiotherapy, cisplatin, cytokines, immune system, growth factors
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-400000DOI: 10.3389/fonc.2019.01177ISI: 000498540700001PubMedID: 31750257OAI: oai:DiVA.org:uu-400000DiVA, id: diva2:1380635
Funder
Swedish Cancer Society, 2015/363The Kamprad Family FoundationAvailable from: 2019-12-19 Created: 2019-12-19 Last updated: 2019-12-19Bibliographically approved

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Astradsson, ThorsteinnSellberg, FelixBerglund, DavidTiblom Ehrsson, YlvaLaurell, Göran
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