title: Early variations of circulating interleukin-6 and interleukin-10 levels during thoracic radiotherapy are predictive for radiation pneumonitis.
abstract: OBJECTIVE
  To investigate variations of circulating serum levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNFalpha), and interleukin-10 (IL-10) during three-dimensional conformal radiation therapy (3D-CRT) in patients with non-small-cell lung cancer and correlate these variations with the occurrence of radiation pneumonitis.
  
  
  METHODS
  Ninety-six patients receiving 3D-CRT for stage I to III disease were evaluated prospectively. Circulating cytokine levels were determined before, every 2 weeks during, and at the end of treatment. Radiation pneumonitis was evaluated prospectively between 6 and 8 weeks after 3D-CRT. The predictive value of clinical, dosimetric, and biologic (cytokine levels) factors was evaluated both in univariate and multivariate analyses.
  
  
  RESULTS
  Forty patients (44%) experienced score 1 or more radiation pneumonitis. No association was found between baseline cytokine levels and the risk of radiation pneumonitis. In the whole population, mean levels of TNFalpha, IL-6, and IL-10 remained stable during radiotherapy. IL-6 levels were significantly higher (P = .047) during 3D-CRT in patients with radiation pneumonitis. In the multivariate analysis, covariations of IL-6 and IL-10 levels during the first 2 weeks of 3D-CRT were evidenced as independently predictive of radiation pneumonitis in this series (P = .011).
  
  
  CONCLUSIONS
  Early variations of circulating IL-6 and IL-10 levels during 3D-CRT are significantly associated with the risk of radiation pneumonitis. Variations of circulating IL-6 and IL-10 levels during 3D-CRT may serve as independent predictive factors for this complication.
authors.affiliation: Department of Pneumology, Hôpital de la Croix Rousse, 103 Grande Rue de la Croix Rousse, 69317 Lyon Cedex 04, France. dominique.arpin@chu-lyon.fr
authors.forename: Dominique
authors.initials: D
authors.lastname: Arpin
authors.forename: David
authors.initials: D
authors.lastname: Perol
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.forename: Lionel
authors.initials: L
authors.lastname: Falchero
authors.forename: Line
authors.initials: L
authors.lastname: Claude
authors.forename: Sylvie
authors.initials: S
authors.lastname: Vuillermoz-Blas
authors.forename: Isabelle
authors.initials: I
authors.lastname: Martel-Lafay
authors.forename: Chantal
authors.initials: C
authors.lastname: Ginestet
authors.forename: Laurent
authors.initials: L
authors.lastname: Alberti
authors.forename: Dimitri
authors.initials: D
authors.lastname: Nosov
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Etienne-Mastroianni
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
authors.forename: Maurice
authors.initials: M
authors.lastname: Perol
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Guerin
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cordier
authors.forename: Christian
authors.initials: C
authors.lastname: Carrie
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008175:Lung Neoplasms / Q000097:blood / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017564:Radiation Pneumonitis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10