Local and Systemic Pathogenesis and Consequences of Regimen-Induced Inflammatory Responses in Patients with Head and Neck Cancer Receiving Chemoradiation
Figure 1
RT/CT-induced inflammatory responses: local and abscopal effects. Intracellular and intercellular signalling loops follow initiation and upregulation due to the local effects of chemoradiation on the exposed tissues. Released cytokines act not only locally but also on other organs and tissues (Interorgan signalling). On muscles they can alter energetic metabolism (thus favouring cachexia). On HPA (hypothalamic-pituitary-adrenal axis) they cause fever and fatigue symptoms. In the liver they provoke the synthesis of acute phase proteins that in turn act in a procoagulative and general inflammatory and antiinflammatory sense. All these effects can lead to systemic inflammatory response syndrome (SIRS) or sepsis. Abbreviations: PaCO2: arterial carbon dioxide tension. For other abbreviations, see the text.
