Plasma Metabolites and Risk of Radiation-induced Esophagitis: A Secondary Analysis from a Prospective Study.
Metabolic profiling was performed on plasma samples obtained prior to and during radiation therapy (RT) for locally advanced lung cancer to identify metabolites predictive of RT-induced esophagitis.



Patients received cisplatin/etoposide with RT as part of a prospective dose-escalation study (n=24). Plasma samples were collected at baseline, weeks 2 and 5 during RT, and 6 weeks post-RT. Metabolites were measured by ultrahigh-performance liquid chromatography-tandem mass spectroscopy at each time-point. Metabolite concentrations were compared between patients developing grade 0-1 and those with grade 2 or more esophagitis.



At baseline, 23 metabolites differed significantly (p<0.05) between patients with grade 0-1 esophagitis and those with grade 2 or esophagitis. Sixty-seven metabolites were different at week 2. None reached statistical significance (q<0.05) after corrections for multiple comparisons. On random forest modeling, the predictive accuracy of the metabolite data was 33% at baseline and 50% at 2 weeks.



No individual metabolite or group of metabolites was predictive of acute RT-induced esophagitis.
Department of Radiation Oncology, Duke University School of Medicine, Durham, NC, U.S.A. daniel.tandberg@duke.edu.
Daniel J
DJ
Tandberg
Metabolon, Inc., Durham, NC, U.S.A.
Tracy
T
Holt
Department of Radiation Oncology, Duke University School of Medicine, Durham, NC, U.S.A.
Chris R
CR
Kelsey
D000368:Aged; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D017321:Clinical Trials, Phase I as Topic; D004941:Esophagitis / Q000097:blood / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy; D008297:Male; D055442:Metabolome / Q000528:radiation effects*; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011832:Radiation Injuries / Q000097:blood / Q000209:etiology / Q000378:metabolism*; D012307:Risk Factors; D053719:Tandem Mass Spectrometry
Lung cancer; biomarkers; esophagitis; metabolomics; radiation therapy