J Korean Soc Ther Radiol Oncol.  2000 Dec;18(4):314-320.

The Measurements of Plasma Cytokines in Radiation-induced Pneumonitis in Lung Cancer Patients

• Hur WJ
• Youn SM
• Lee HS
• Yang KM
• Oh SG
• Son CH
• Han JY
• Lee KN
• Jeong MH

Abstract

PURPOSE
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Radiotherapy; Radiation Pneumonitis; Cytokines

MeSH Terms

Cytokines*
Enzyme-Linked Immunosorbent Assay
Follow-Up Studies
Humans
Interleukin-6
Lung Neoplasms*
Lung*
Plasma*
Pneumonia*
Prospective Studies
Radiation Pneumonitis
Radiotherapy
Transforming Growth Factor beta1
Tumor Necrosis Factor-alpha
Cytokines
Interleukin-6
Transforming Growth Factor beta1
Tumor Necrosis Factor-alpha