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.

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.

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.

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