Faecal calprotectin and lactoferrin values during irradiation of prostate cancer correlate with chronic radiation proctitis: results of a prospective study.
OBJECTIVE
Acute proctitis and chronic radiation proctitis are relevant complications of pelvic radiation. The purpose of this study was to investigate two markers of gut inflammation during and after irradiation for prostate cancer to evaluate a correlation between acute and chronic proctitis.


METHODS
Two patient groups were analysed. In group 1, stool samples from 20 patients were collected before therapy, every week during therapy, at the end of therapy, and 13 and 27 months after therapy. Group 2 comprised 47 patients who had undergone irradiation 40 months earlier. Toxicity was determined by common toxicity criteria (CTC) and the LENT soma scale. Calprotectin and lactoferrin values were determined by ELISA.


RESULTS
In group 1, acute values for both faecal markers were significantly correlated with chronic proctitis symptoms and all patients with chronic toxicity had acute proctitis symptoms with elevated faecal values. In group 2, where stool samples were solely collected 40 months after irradiation, the Pearson square test showed both a significant correlation between calprotectin and lactoferrin values and toxicity after 40 months.


CONCLUSIONS
Within a group of 19 patients followed for two years after irradiation for prostate cancer, and 47 patients tested 40 months after irradiation, increased faecal values of calprotectin and lactoferrin were significantly correlated with the occurrence of chronic proctitis. This observation should be confirmed in an expanded study.
Hille
Andrea
A
Department of Radiotherapy and Radio-oncology, University of Göttingen, Göttingen, Germany. ahille@med.uni-goettingen.de
Rave-Fränk
Margret
M
Christiansen
Hans
H
Herrmann
Markus K A
MK
Kertesz
Tereza
T
Hermann
Robert M
RM
Wolff
Hendrik A
HA
Schirmer
Markus
M
Hess
Clemens F
CF
Ramadori
Giuliano
G
D000368:Aged; D015415:Biomarkers / Q000032:analysis; D005243:Feces / Q000737:chemistry*; D006801:Humans; D007781:Lactoferrin / Q000032:analysis; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D011349:Proctitis / Q000209:etiology*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis*
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex; D007781:Lactoferrin