title: Lipopolysaccharide-binding protein is efficient in biodosimetry during radiotherapy of lung cancer.
abstract: The aim of the present study was to determine if the serum levels of early markers of inflammation, such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and lipopolysaccharide-binding protein (LBP) were correlated with the radiation dose received by the pulmonary and mediastinal structures of patients with non-small cell lung cancer (NSCLC). This pilot study included 26 patients with NSCLC who received total radiation doses ranging from 54 to 74 Gy (2.0 Gy/fraction). Cytokines were measured at baseline by enzyme-linked immunosorbant assay, and following administration of total doses of 20 and 40 Gy. A control group of 26 participants was sampled for comparisons with patient baseline cytokine levels. Only data from the 40-Gy cytokine blood levels of patients with NSCLC were identified to be correlated with histograms of the parameters of each patient's radiotherapy protocol. The IL-6, TNF-α and CRP median baseline levels of the patients with NSCLC were significantly higher than those of the controls (all P≤0.01). No differences were observed between the LBP levels of the patients and controls [median, 36.34 (25-75%; 31.35-39.27) vs. 36.92 (30.20-44.05) µg/ml, respectively; P=0.42]. No significant differences in the levels of the four cytokines between baseline, and at 20 and 40 Gy were observed [IL-6 (P=0.19); TNF-α (P=0.68); CRP (P=0.44) and LBP (P=0.29)]. LBP was significantly and positively correlated with the mean radiation dose to the lung (r=0.409; P=0.038), and showed a positive correlation with the percentage of lung volume exposed to at least 20 Gy of the planned radiation dose (r=0.3536; P=0.0764). CRP levels were positively correlated with the mean radiation dose to the esophagus (r=0.404; P=0.041); however, IL-6, TNF-α and CRP were not significantly associated with other lung dosimetry parameters. Thus, LBP levels were correlated with radiation exposure of pulmonary tissues, and LBP may be a marker that warrants further investigation on radiotoxicity in NSCLC patients.
authors.affiliation: Department of Radiotherapy, Medical University of Łódź, 93-509 Łódź, Poland.
authors.forename: Justyna
authors.initials: J
authors.lastname: Chalubinska-Fendler
authors.affiliation: Department of Biostatistics and Translational Medicine, Medical University of Łódź, 91-738 Łódź, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Fendler
authors.affiliation: Department of Radiotherapy, Medical University of Łódź, 93-509 Łódź, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Spych
authors.affiliation: Department of Paediatrics, Oncology, Haematology and Diabetology, Medical University of Łódź, 91-738 Łódź, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Wyka
authors.affiliation: Department of Brachytherapy, Regional Oncological Centre, 93-509 Łódź, Poland.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Luniewska-Bury
authors.affiliation: Department of Radiotherapy, Medical University of Łódź, 93-509 Łódź, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Fijuth
keywords: adverse effects; biodosimetry; lipopolysaccharide-binding protein; lung cancer; radiotherapy; toxicity