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J Korean Soc Ther Radiol Oncol > Volume 18(4); 2000 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2000;18(4): 314-320.
The Measurements of Plasma Cytokines in Radiation-induced Pneumonitis in Lung Cancer Patients
Won Joo Hur, Seon Min Youn, Hyung Sik Lee, Kwang Mo Yang, Sin Geun Oh, Choon Hee Son, Jin Yeong Han, Ki Nam Lee, Min Ho Jeong
1Department of Radiation Oncology, Dong-A University, College of Medicine, Pusan, Korea.
2Department of Internal Medicine, Dong-A University, College of Medicine, Pusan, Korea.
3Department of Diagnostic Radiology, Dong-A University, College of Medicine, Pusan, Korea.
4Department of Clinical Pathology, Dong-A University, College of Medicine, Pusan, Korea.
5Institute of Medical Science, Dong-A University, College of Medicine, Pusan, Korea.
To investigate whether changes in plasma concentrations of transforming growth factor-beta1 (TGF-beta1), tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) could be used to identify the development of radiation-induced pneumonitis in the lung cancer patients. METHODS AND MATERIALS: Seventeen patients with lung cancer (11 NSCLC, 6 SCLC) were enrolled in a prospective study designed to evaluate clinical and molecular biologic correlation of radiation-induced pneumonitis. The study began in May 1998 and completed in July 1999. All patients were treated with radiotherapy with curative intent : 1.8 Gy per day, 5 fractions per week. Serial measurements of plasma TGF-beta1, TNF-alpha and IL-6 were obtained in all patients before, weekly during radiotherapy and at each follow-up visits after completion of treatment. These measurements were quantified using enzyme linked immunosorbent assay (ELISA). All patients were evaluated for signs and symptoms of pneumonitis at each follow-up visit after completion of radiotherapy. High resolution CT (HRCT) scans were obtained when signs and symptoms of pneumonitis were developed after completion of radiotherapy.
Thirteen patients eventually developed signs and symptoms of clinical pneumonitis while four patients did not. TGF-beta1 levels were elevated in all 13 patients with pneumonitis, which showed characteristic pattern of elevation (38.45 ng/ml at pretreatment, 13.66 ng/ml during radiotherapy, then 60.63 ng/ml at 2-4 weeks after completion of radiotherapy). The levels of TNF-alpha and IL-6 were also elevated in the group of patients who developed pneumonitis but the pattern was not characteristic.
Changes in plasma TGFbeta-1 levels before, during and after radiotherapy appears to be a useful means by which to identify patients at risk for the development of symptomatic pneumonitis. Other cytokines like TNF-alpha and IL-6 shows no meaningful changes in association with radiation pneumonitis.
Key Words: Radiotherapy, Radiation Pneumonitis, Cytokines
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