Wound healing following combined radiation and cetuximab therapy in head and neck cancer patients.

OBJECTIVE: This study set out to determine if cetuximab treatment increases the risk of wound healing complications when combined with radiation therapy. METHOD: We performed a retrospective chart review of head and neck cancer patients who received salvage neck dissections between 1999 and 2007, at two academic tertiary care centres. Complications from wound healing were compared between radiation and combined therapy groups. RESULTS: A total of 35 patients received radiation (n=20) or combined radiation and cetuximab therapy (n=15) prior to neck dissection. The treatment groups were similar in regard to demographic and primary tumour-related characteristics. The time between treatment and salvage neck dissection did not differ between the radiation (3.9 months) and combination treatment (3.0 months) groups (p=0.15). Wound healing complications occurred in 13% (2/15) of the patients treated with radiation and cetuximab and there were no complications in patients who received radiation alone (p=0.20). CONCLUSION: Cetuximab did not significantly increase the risk of post-surgical wound complications, although a higher absolute number of wound complications was observed in the group treated with cetuximab and radiation therapy, compared with the group treated with radiation alone. CONFLICT OF INTEREST: This work was supported by a grant from the National Institute of Health (2T32 CA091078-06). One of the authors, JAB, is an occasional consultant and honoraria for ImClone and Bristol-Meyers Squibb.

Lymphokine activated killer cell activity following voluntary physical activity in mice.

The effect of eight weeks of voluntary wheel running exercise in female, outbred Swiss Webster mice on baseline splenic natural killer (NK) cell and interleukin-2 stimulated lymphokine activated killer (LAK) cell activity was studied. NK cell cytolytic activity against YAC-1 tumour targets was measured using a 51Cr release assay at the completion of a wheel running episode (end of dark cycle) or at 96 h after cessation of wheel running. LAK cell activity against tumour targets was generated from splenic NK cells by in vitro stimulation for 3 days with recombinant interleukin-2 (rIL-2). Wheel running was not associated with increases in baseline NK cytolytic activity either when sampled as a training effect (96 h after exercise) or immediately after exercise. Following an episode of wheel running exercise, LAK activity was significantly higher in the physically active compared to sedentary animals. These results support the concept that spontaneous wheel running activity enhances lymphokine activated killer cell activity following a cycle of active running; whether this greater LAK activity involves changes in IL-1, IL-2, or other cytokine concentrations or in the expression of IL-2 receptors on NK/LAK cells after exercise warrants further investigation. Given the clinical use of IL-2 to stimulate LAK cells in adoptive immunotherapy, it is possible (although untested) that exercise may have a potentially beneficial role as a treatment modality for some human cancers.