DYNAMICS OF CYTOKINE PROFILE IN CANCER PATIENTS WITH CHEMO-RAY ORAL MUCOSITIS DURING TREATMENT
Abstract and keywords
Abstract (English):
Relevance. According to the WHO scale, mucositis of 3-4 degrees is a severe injury among patients receiving high-dose radiation and chemotherapy for the head and neck region, the frequency of which reaches 85%. Dental treatment of such patients is extremely important, more often it is symptomatic and is aimed at improving their well-being and limiting the spread of the process, particularly oral mucositis. The aim of this study was to increase the effectiveness of the prevention of oral mucositis in patients with COR cancer against the background of systemic chemoradiation treatment. Material and methods. We examined 89 patients with a diagnosis of oral mucosa cancer (C00-C06, C10, C13, C14) according to ICD-10) II and III stages (T2-3, N0-1, M0), aged from 55 to 67 years, who received chemo-radiation therapy for the head and neck area. To rate immune status, in particular the mechanisms of regulation of protective reactions at the local level, patients with mucositis in the oral fluid were examined and it was determined by the content of pro-inflammatory and anti-inflammatory interleukins (IL), the concentration of cytokines in saliva was determined by ELISA. Depending on the method of treatment, patients were divided into two groups: comparison (traditional treatment) and main (developed method). Results. The concentration of proinflammatory IL-1b in the saliva of patients before starting treatment averaged 126.14 ± 45.01 pg/ml and anti-inflammatory IL-10 at 94.96 ± 44.20 pg/ml. Laetrile has a short-term local effect, which slightly affects the cytokine profile of saliva, the concentration of IL-1 increases by the 5th day, and IL-10 decreases 2.2 times. The concentration of cytokines before treatment was 64.55 ± 22.85 pg/ml and tended to gradually increase by the 7th day. For IL-10, the values were also low. Thus, a significant individual difference in the content of these cytokines was revealed, reflecting the sensitivity to both radiation and local therapy.

Keywords:
oral mucositis, cytokine, treatment, radiation therapy, chemotherapy
References

1. Avanesov A.M., Gvozdikova E.N., Haydar D.A., Tarasova T.V., Saushev I.V., Tyurina E.P. Stomatologicheskiy status pacientov s ploskokletochnoy karcinomoy orofaringeal'noy oblasti. Issledovaniya i praktika v medicine. 2019;6(4):109-115. [A.M. Avanesov, E.N. Gvozdikova, D.A. Khaydar, T.V. Tarasova, I.V. Saushev, E.P. Tyurina. Dental status of patients with squamous cell carcinoma of the oropharyngeal region. Research and Practical Medicine Journal. 2019;6(4):109-115. (In Russ.)]. https://doi.org/10.17709/2409-2231-2019-6-4-11

2. Avanesov A.M., Gvozdikova E.N. Opredelenie grupp stomatologicheskogo riska razvitiya luchevogo mukozita u bol'nyh s ploskokletochnym rakom orofaringeal'noy oblasti na fone luchevoy terapii. Luchevaya diagnostika i terapiya. 2017;2(8):66. [A.M. Avanesov, E.N. Gvozdikova.The definition of the group dental risk of development of radiation mucositis in patients with carcinoma of the oropharyngeal region during radiation therapy. Radiation diagnostics and therapy. 2017;2(8):66. (In Russ.)]. https://elibrary.ru/item.asp?id=29752341

3. Avanesov A.M., Gvozdikova E.N., Tarasova T.V., Haydar D.A., Vinogradova A.A., Zaharkin I.A. Vliyanie kachestva individual'noy gigieny polosti rta na tyazhest' postluchevogo mukozita u pacientov s ploskokletochnym rakom orofaringeal'noy oblasti. Yuzhno-rossiyskiy onkologicheskiy zhurnal. 2020;1(2):6-12. [A.M. Avanesov, E.N. Gvozdikova, T.V. Tarasova, D.A. Khaydar, A.A. Vinogradova, I.A. Zakharkin. Individual oral hygiene quality influence on the severity of post-radiation mucositis in patients with squamous cell carcinoma of the oropharyngeal region. South Russian Journal of Cancer. 2020;1(2):6-12. (In Russ.)]. https://doi.org/10.37748/2687-0533-2020-1-2-1

4. Ahmadova M.A., Soyher M.I., Chuyanova E.Yu. Onkonastorozhennost' v praktike vracha-stomatologa. Medicinskiy alfavit. 2016;2(9):6-9. [M.A. Amkhadova, M.I. Soykher, E.Yu. Chuyanova. Concern over oncology in practice of dentist. The medical alphabet. 2016;2(9):6-9. (In Russ.)]. https://elibrary.ru/item.asp?id=26738839

5. Bel'skaya L.V. Vozmozhnye primeneniya slyuny dlya diagnostiki raka. Klinicheskaya laboratornaya diagnostika. 2019;64(6):333-336. [L.V. Bel'skaya. Possible applications of saliva for the diagnosis of cancer.Clinical laboratory diagnostics. 2019;64(6):333-336. (In Russ.)]. https://doi.org/10.18821/0869-2084-2019-64-6-333-336

6. Bel'skaya L.V. Vozmozhnosti primeneniya slyuny dlya diagnostiki onkologicheskih zabolevaniy. Klinicheskaya laboratornaya diagnostika. 2019;64(6):333-336. [L.V. Bel'skaya. Possible applications of saliva for the diagnosis of cancer. Clinical laboratory diagnostics. 2019;64(6):333-336. (In Russ.)]. https://doi.org/10.18821/0869-2084-2019-64-6-333-336

7. Gvozdikova E.N. Osobennosti taktiki lecheniya oral'nyh mukozitov u onkologicheskih bol'nyh na fone luchevogo lecheniya i/ili himioterapii : dis. ... kandidata Medicinskih nauk. 14.01.12. / [FGBU «Rossiyskiy nauchnyy centr rentgenoradiologii» Ministerstva zdravoohraneniya Rossiyskoy Federacii]. 2018:152. [E.N. Gvozdikova. Features of the tactics of treatment of oral mucositis in cancer patients on the background of radiation treatment and / or chemotherapy : dis. ... candidate of Medical Sciences. 14.01.12. FSBI "Russian Scientific Center of Radiology" of the Ministry of Health of the Russian Federation. 2018:152. (In Russ.)]. https://elibrary.ru/item.asp?id=42591573

8. Gel'fand I.M., Romanov I.S., Udincov D.B. Taktika lecheniya lokalizovannyh form raka slizistoĭ obolochki polosti rta. Opuholi golovy i shei. 2016;6(1):43-45. [I.M. Gel’fand, I.S. Romanov, D.B. Udintsov. Treatment policy for localized oral cancer. Head and Neck Tumors (HNT). 2016;6(1):43-45. (In Russ.)]. https://doi.org/10.17650/2222-1468-2016-6-1-43-45

9. Eremina A.O, Zaderenko I.A., Ivanov S.Yu. i dr. Oral'nye mukozity u pacientov s onkologicheskoy patologiey orofaringeal'noy oblasti: obzor literatury. Opuholi golovy i shei 2020;10(3):72-80. [A.O. Eremina, I.A. Zaderenko, S.Yu. Ivanov et al. Oral Mucozosites in patients with orofaringeal region on cancer: literature review. Head and neck tumors 2020;10(3):72-80. (In Russ.)]. https://doi.org/10.17650/2222-1468-2020-10-3-72-80

10. Red. Kaprin A.D. Zlokachestvennye novoobrazovaniya polosti rta. Klinicheskie rekomendacii. Moskva. 2020:62. [Ed. A.D. Kaprin. Malignant neoplasms of the oral cavity. Clinical recommendations. Moscow. 2020:62. (In Russ.)]. https://sudact.ru/law/klinicheskie-rekomendatsii-zlokachestvennye-novoobrazovaniia-polosti-rta-utv/klinicheskie-rekomendatsii

11. Red. Kaprin A.D., Starinskiy V.V., Petrova G.V. Zlokachestvennye novoobrazovaniya v Rossii v 2018 godu (zabolevaemost' i smertnost'). Moskva : MNIOI im. P.A. Gercena. 2019:250. [Eds. A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Malignant tumors in Russia in 2017 (morbidity and mortality). Moscow : MNIOI im. P.A. Gertzena. 2018:250. (In Russ.)]. https://glavonco.ru/cancer_register/Zabol_2018_Elektr.pdf.

12. Dibirov R.K., Yaremenko A.I., Kutukova S.I., Manihas G.M. Klinicheskaya znachimost' markerov kletochnogo cikla pri rake slizistoy obolochki polosti rta. Vrach-aspirant. 2013;58(3):11-17. [R.K. Dibirov, A.I. Yaremenko, S.I. Kutukova, G.M. Manikhas. The clinical significance of cell cycle by squamous cell cancer of the oral cavity. Postgraduate Doctor. 2013;58(3):11-17. (In Russ.)]. https://elibrary.ru/item.asp?id=19022101

13. Romanenko I.G., Arakelyan K.A.,Salischeva V.O. Sovremennye koncepcii profilaktiki i lecheniya oral'nogo mukozita pri onkoterapii. Vyatskiy medicinskiy vestnik. 2021;1(69).[I.G. Romanenko, K.A. Arakelyan, V.O. Salishcheva. Modern concepts of prevention and treatment of oral mucositis in cancer therapy. Journal of Medical Gazette Vyatka. 2021;1(69). (In Russ.)]. https://doi.org/10.24411/2220-7880-2021-10161

14. Rubenshteyn E.B. Prakticheskoe klinicheskoe rukovodstvo po profilaktike i lecheniyu oral'nogo mukozita i mukozita zheludochnokishechnogo trakta posle protivoopuholevoy rakovoy terapii. Stomatologiya. 2014;2:114-122. [E.B. Rubenstein. Practical clinical guidelines for the prevention and treatment of oral mucositis and gastrointestinal mucositis after cancer therapy. Dentistry. 2014;2:114-122. (In Russ.)]. http://nbuv.gov.ua/UJRN/ss_2014_2_24

15. Samedov V.H., Naleskina L.A., Zaharychev V.D. Associativnaya svyaz' mezhdu morfologicheskimi osobennostyami rosta i klinicheskim techeniem raka polosti rta. Rossiyskiy onkologicheskiy zhurnal. 2014;2:16-22. [V.Kh. Samedov, L.A. Naleskina, V.D. Zakharychev. Association between the morphological characteristics of growth and the clinical course of oral cancer. Russian Journal of Oncology. 2014;2:16-22. (In Russ.)]. https://elibrary.ru/item.asp?id=21520265

16. Mezhevikina G.S., Gluhova E.A. Sovremennye metody diagnostiki predrakovyh i rakovyh izmeneniy slizistoy obolochki rta. Nauka Molodyh. 2018;6(4):600-606. [G.S. Mezhevikina, E.A. Glukhova. Modern diagnostic methods precancerous and cancerous changes of the oral mucosa. Eruditio Juvenium. 2018;6(4):600-606. (In Russ.)]. https://doi.org/10.23888/HMJ201864600-606

17. Davydov M.I., Shestopalova I.M., Semenovich C.S., Komarova L.E. Statistika zlokachestvennyh novoobrazovaniy v Rossii i stranah SNG. Vestnik RONC im. H.H. Blohina RAMN. 2009;20:3(77):158. [M.I. Davydov, I.M. Shestopalova, S.S. Gerasimov, L.E. Komarova. Prospects for cure in cases with concomitant thoracoabdominal cancer and ischemic heart disease. Bulletin of the Russian Oncology Center H.H. Blokhin Russian Academy of Medical Sciences. 2009;20;3(77):158. (In Russ.)]. https://elibrary.ru/item.asp?id=13080151

18. Bykov V.L., Leont'eva I.V. Tkanevye i kletochnye vzaimodeystviya v slizistoy obolochke polosti rta pri vvedenii citostatikov. Morfologiya. 2011;139(3):7-18. [V.L. Bykov, I.V. Leontiyeva. Tissue and cell interactions in the oral mucosa after cytostatic drugs administration. Morphology. 2011;139(3):7-18. (In Russ.)]. https://elibrary.ru/item.asp?id=16567339

19. Chernov V.M., Ptushkin V.V. Anemiya u pacientov s onkologicheskimi zabolevaniyami: sovremennye vozmozhnosti lecheniya (obzor literatury). Onkogematologiya. 2013;8(2):77-82. [V.M. Chernov, V.V. Ptushkin. Anemia in cancer patients: current treatment options (review). Oncohematology. 2013;8(2):77-82. (In Russ.)]. https://doi.org/10.17650/1818-8346-2013-8-2-77-82

20. Chen S.C. Oral dysfunction in patients with head and neck Cancer: a systematic review // J Nurs Res. - 2019;27(6):e58. https://doi.org/10.1097/jnr.0000000000000363

21. Diaz-Sanchez R.M., Pachón-Ibáñez J., Marín-Conde F. et al. Double-blind, randomized pilot study of bioadhesive chlorhexidine gel in the prevention and treatment of mucositis induced by chemoradiotherapy of head and neck cancer // Med Oral Patol Oral Cir Bucal. - 2015;20(3):378-385. https://doi.org/10.4317/medoral.20338

22. Kalavrezos N. et al. Factors affecting swallow outcome following treatment for advanced oral and oropharyngeal malignancies // Head Neck. - 2014;36:47-54. https://doi.org/10.1186/s40463-020-00479-6

23. Al-Mamgani A. et al. Intensity-modulated radio therapy followed by a brachytherapy boost for oropharyngeal cancer // Head Neck. - 2013;35:1689-1697. https://doi.org/10.1002/hed.23244.

24. Lalla R.V., Bowen J., Barasch A. et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy // Cancer. - 2014;120(10):1453-1461. https://doi.org/10https://doi.org/10.1002/cncr.28592.

25. Platek M.E. et al. Quantification of the effect of treatment duration on local-regional failure after definitive concurrent chemotherapy and intensity-modulated radiation therapy for squamous cell carcinoma of the head and neck // Head Neck. - 2013;35:684-688. https://doi.org/10.1002/hed.23024

26. Khaw A. Et al. Radiation-induced oral mucositis and periodontitis - proposal for an inter-relationship // Oral Diseases. - 2014;20:7-18. https://doi.org/10.1111/odi.12199

27. Siegel R.L., Miller K.D., Jemal A. Cancer statistics // A Cancer Journal for Clinicians. - 2017;67(1):7-30. https://doi.org/10.3322/caac.21387

28. Traktama D.O., Sufiawati I. Oral mucositis severity in patient with head and neck cancer undergoing chemotherapy and/or radiotherapy // Majalah Kedokteran Gigi Indonesia. - 2018;4(1):52. https://doi.org/10.22146/majkedgiind.33709


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