Abstract
BackgroundCirculating interleukin-6 (IL-6) improves outcome prediction for second primary cancer (SPC) in head and neck cancer (HNC) patients. This study aimed to identify factors associated with IL-6 serum levels in HNC patients.MethodsThis study was conducted as part of a phase III chemoprevention trial. IL-6 was measured using chemiluminescent immunometric assay on pretreatment serum sample obtained from 527 stage I-II HNC patients. Patients’ lifestyle habits, sociodemographic, medical and tumor characteristics were evaluated before radiation therapy (RT). Factors independently associated with IL-6 levels before RT were identified using multiple linear regression.ResultsThe median IL-6 serum level was 3.1 ng/L. In the multivariate analysis, eight factors were significantly associated (p < 0.05) with IL-6: age, gender, marital status, body mass index, tobacco consumption, comorbidities, Karnofsky Performance Status and HNC site. Smoking duration and lifetime pack-years were positively associated with IL-6 serum levels in a dose-response relationship (p-value for trend ≤0.03).ConclusionsCirculating IL-6 is a strong predictor of the occurrence of SPC in HNC patients. We identified eight factors independently associated with serum IL-6 levels in 527 stage I-II HNC patients.The dose-response relationship between lifetime smoking and IL-6 serum levels suggested a causal role of tobacco exposure on IL-6 production. Further studies are needed to establish whether the effect of tobacco exposure on SPC could be partly mediated by IL-6, a pro-inflammatory cytokine.
Highlights
Circulating interleukin-6 (IL-6) improves outcome prediction for second primary cancer (SPC) in head and neck cancer (HNC) patients
We reported that higher pre-treatment IL-6 serum levels were significantly
Use of tobacco products during the previous year was reported by 70.6% of the HNC patients, while 4.9% reported never having consumed tobacco products during their life
Summary
Circulating interleukin-6 (IL-6) improves outcome prediction for second primary cancer (SPC) in head and neck cancer (HNC) patients. This study aimed to identify factors associated with IL-6 serum levels in HNC patients. Patients with a history of HNC are at high risk for developing second primary cancers (SPC) [4] as, within 5 years, about 20% will be diagnosed with one or more multiple primary cancers, which strongly compromises their survival. In a recent cohort study conducted among 6545 middle-aged adults, IL-6 serum level was able to predict all-causes and cancer-related mortalities over a period of 17 years [11]. Strong evidence from a meta-analysis showed that higher IL-6 serum levels were associated with poor prognosis in non-small cell lung cancer patients [12]. We reported that higher pre-treatment IL-6 serum levels were significantly
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