cytokine plasma levels reliable predictors for radiation pneumonitis血浆细胞因子水平的可靠预测辐射肺炎.pdfVIP

Cytokine Plasma Levels: Reliable Predictors for Radiation Pneumonitis? ¨ 1 1 2 1 ¨ 3 4 Claudia E. Rube , Jan Palm , Michael Erren , Jochen Fleckenstein , Jochem Konig , Klaus Remberger , ¨ 1* Christian Rube 1 Department of Radiotherapy and Radiooncology, Saarland University, Homburg/Saar, Germany, 2 Institute of Clinical Chemistry and Laboratory Medicine, University of ¨ ¨ Munster, Munster, Germany, 3 Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg University, Mainz, Germany, 4 Department of Pathology, Saarland University, Homburg/Saar, Germany Abstract Background: Radiotherapy (RT) is the primary treatment modality for inoperable, locally advanced non-small-cell lung cancer (NSCLC), but even with highly conformal treatment planning, radiation pneumonitis (RP) remains the most serious, dose-limiting complication. Previous clinical reports proposed that cytokine plasma levels measured during RT allow to estimate the individual risk of patients to develop RP. The identification of such cytokine risk profiles would facilitate tailoring radiotherapy to maximize treatment efficacy and to minimize radiation toxicity. However, cytokines are produced not only in normal lung tissue after irradiation, but are also over-expressed in tumour cells of NSCLC specimens. This tumour-derived cytokine production may influence circulating plasma levels in NSCLC patients. The aim of the present study was to investigate the prognostic value of TNF-a, IL-1b, IL-6 and TGF-b1 plasma levels to predict radiation pneumonitis and to evaluate the impact of tumour-derived cy