Serum proinflammatory cytokine response in patients with advanced liver tumors following selective internal radiation therapy (SIRT) with (90)Yttrium microspheres.
OBJECTIVE
To determine the changes in serum levels of proinflammatory cytokines within 48 h after selective internal radiation treatment (SIRT) in patients with advanced liver cancers.


METHODS
Twenty-eight patients with advanced liver cancers who underwent SIRT were recruited into the study. Serum levels of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha, and interferon-gamma were determined prior to and 3, 6, 12, 24, and 48 h after SIRT. Their changes were correlated to adverse reactions following treatment as assessed by constitutional symptom scores, and routine blood and liver function tests at 24 and 48 h post-SIRT and falls in serum carcinoembryonic antigen (CEA) level 1 month post-SIRT.


RESULTS
Serum IL-6 levels were significantly increased at 24 (p < or = 0.05) and 48 h (p < or = 0.01) post-SIRT. In contrast, there was no significant change in the serum levels of other cytokines studied. The increase in serum IL-6 at 24 h post-SIRT was significantly correlated with the changes in serum alanine transferase (p < or = 0.05) and C-reactive protein (p < or = 0.001) levels and total leukocyte counts (p < or = 0.001) at both 24 and 48 h post-SIRT. Changes in serum IL-6 level were also significantly correlated to the rise of serum aspartate transaminase levels at 48 h post-SIRT (p < or = 0.001), but not with the scores of constitutional symptoms or the changes of serum CEA at 1 month post-SIRT.


CONCLUSIONS
Absence of significant changes in most of proinflammatory cytokines studied confirmed that SIRT is a reasonably safe and well-tolerated treatment with minimal side-effect from the point of view of cytokine-related inflammation. The correlation of serum IL-6 changes with several liver enzymes and C-reactive protein but not with clinical symptom scores or serum CEA levels suggests that the rise in IL-6 levels in the first 48 h following SIRT most likely reflect normal liver cell damage rather than tumor cell damage.
Wakefield Gastroenterology Centre and Research Institute, Wakefield Hospital, Wellington, Newtown, New Zealand.
J K
JK
Wickremesekera
W
W
Chen
R J
RJ
Cannan
R S
RS
Stubbs
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002097:C-Reactive Protein / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000097:blood; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007378:Interleukins / Q000097:blood*; D007958:Leukocyte Count; D008113:Liver Neoplasms / Q000097:blood* / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D002272:Carcinoembryonic Antigen; D015850:Interleukin-6; D007378:Interleukins; D009363:Neoplasm Proteins; D014409:Tumor Necrosis Factor-alpha; D015021:Yttrium Radioisotopes; D007371:Interferon-gamma; D002097:C-Reactive Protein; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase