[Correlation study of physical and biologic parameters to acute radiation pneumonitis].
OBJECTIVE
To study the relationship between the level of plasma transform growth factor-betal (TGF-betal), interleukin-6 (IL-6), thrombomodulin (TM) dose-volume factors and acute radiation pneumonitis (ARP).


METHODS
Three dimensional conformal radiation therapy and chemotherapy were applied to 27 lung cancer patients, 15 esophageal carcinoma, and 1 thymoma patients. 19 patients received adjuvant radiochemotherapy, and 25 patients received concurrent radio-chemotherapy. Enzyme-linked immunosorbent assay (ELISA) was applied to detect the serum IL-6, TGF-betal and TM levels of patients before radiotherapy (B-RT) and at 30 Gy(M-RT). ARP was graded according to NCI common toxicity criteria (CTCAE v 3.0), Grade 2 or more ARP was taken as the main end point. The relationship between the levels of serum TGF-betal, IL-6, TM, parameters of lung function and dose-volume factors, and the incidence rate of ARP were analyzed. Mean lung dose (MLD) and the Vx were considered as the dose-volume factors.


RESULTS
Among 44 patients, 15 of them had ARP. 9 got grade 2 ARP and 6 had grade 3. After received a dose of 30 Gy, TGF-betal value in M-RT was (396 +/- 338) and (866 +/- 270) pg/mL in non-ARP and ARP group (P = 0.000). The ARP incidence rate in <60 and > or =60 age group were 46.15% (12/26) and 16.67% (3/18) (P = 0.042), and 45.45% (15/33), 0% (0/11) (P = 0.017) in had smoking history and nonsmoking history group, respectively. 1 out of 13 patients (7.69%) who had increased M-RT TM value suffered of ARP, while 14 out of 31 patients (45.16%) whose M-RT TM value lower than pr-RT suffered of ARP (P = 0.044). The results of multivariate analysis implied that the MLD and the value of TGF-betal in M-RT were associated with severe ARP.


CONCLUSIONS
TGF-beta1 and MLD are significant indicators of ARP. FEV1 actual value/predicted value% might have predicting effect for the severity of ARP.
Zhao
Yan-hai
YH
Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu 610041, China.
Li
Zhi-ping
ZP
Chen
Xiao-mei
XM
Liu
Xiao-jing
XJ
Wu
Wen-chao
WC
Xu
Yong
Y
Li
Ping
P
Zhang
Jin-tao
JT
Zeng
Hui
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging; D002681:China; D004938:Esophageal Neoplasms / Q000532:radiotherapy; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D017564:Radiation Pneumonitis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D011859:Radiography; D018180:Thrombomodulin / Q000097:blood*; D053773:Transforming Growth Factor beta1 / Q000097:blood*
D015850:Interleukin-6; D018180:Thrombomodulin; D053773:Transforming Growth Factor beta1