Romanian Society of Pharmaceutical Sciences
 

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NUTRITIONAL STATUS AND SALIVARY CYTOKINE DYNAMICS IN PATIENTS WITH HEAD AND NECK CANCERS UNDERGOING RADIOTHERAPY

SIMONA CRISTINA MARINESCU 1,2, MIRUNA-MARIA APETROAEI 1*, MANUELA GHICA 1 , VERGINICA SCHRÖDER 3, GABRIELA PURA 4, BRUNO ȘTEFAN VELESCU 1, ANDREEA LETITIA ARSENE 1,3, DENISA IOANA UDEANU 1,3

1 Faculty of Pharmacy, ”Carol Davila” University of Medicine and Pharmacy, 6, Traian Vuia Street, 020956 Bucharest, Romania
2 Amethyst Radiotherapy Centre, 42, Drumul Odăi, 075100 Otopeni, Romania
3 Faculty of Pharmacy, ”Ovidius” University of Constanta, 6 Capt. Aviator Al. Șerbănescu Street, Campus C, 900470 Constanta, Romania
4 Faculty of Pharmacy, ”Iuliu Hațeganu” University of Medicine and Pharmacy, 8, Victor Babeș Street, 400347, Cluj-Napoca, Romania
5 ”Marius Nasta” Institute of Pneumophthiology, 90, Viilor Street, 050159 Bucharest, Romania

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This study evaluated the nutritional status and salivary inflammatory cytokines in patients with head and neck cancer (HNC) undergoing radiotherapy. Anthropometric parameters, NRS-2002 scores, and salivary IL-1β and IL-6 were assessed before and after treatment. BMI decreased significantly during therapy (p = 5.16×10⁻⁶), accompanied by a rise in nutritional risk, with NRS-2002 ≥ 3 increasing from 25.8% to 51.6%. Higher baseline NRS-2002 scores were significantly associated with subsequent percutaneous endoscopic gastrostomy placement (p = 0.0007). Salivary IL-1β increased significantly at treatment completion compared with baseline and controls, consistent with radiation-induced mucosal inflammation. IL-6 levels were significantly higher in patients than in healthy subjects at both time points (p = 0.0142 and p = 0.00055), but did not increase further during radiotherapy (p = 0.0997), which might suggest a predominantly tumour-driven chronic IL-6 activation. These findings indicate concurrent declines in nutritional status and dysregulation of inflammation during radiotherapy. Moreover, our results highlight the need for early, targeted nutritional strategies during radio/chemotherapy and support the exploration of anti-inflammatory or cytokine-modulating interventions as adjuncts to optimise therapeutic tolerance and outcomes.