Clinical And Laboratory Study On Factors Associated With Radiation-induced-Lung-Injury.

Part I: Predicting effect of plasma TGF-beta, IL-6, and ACE levels in radiationpneumonitisObjective: To study the relationship between plasma transforming growth factor-beta (TGF-beta), interleukin-6 (IL-6), and angiotensin-converting enzyme (ACE) levels and radiation pneumonitis. materials and methods: All eligible patients were treated with radiotherapy with or without chemotherapy. Blood sample were collected and frozen before radiotherapy (pre-RT) and at the time of 40-50Gy irradiation (post-RT). TGF-beta, IL-6, and ACE levels were all measured with enzyme-linked immunosorbent assay (ELISA) methods. Radiation pneumonitis (RP) were graded according to RTOG/EORTC acute radiation pneumonitis criteria. Grade 2 or worse radiation pneumonits was used as end point. Analysis was performed using SPSS 10.0 software. Results: There were 42 patients enrolled in this study from Feb 2004 to Dec 2004. Radiation doses ranged from 46Gy to 70Gy, with median dose 60Gy. Chemotherapy was administered to 35 cases, among which 20 cases received concurrent cheomoradiotherapy. There were 13 cases developed RP, accounting for 31.0% of all patients. Between RP and non-RP group, there was no significant difference in TGF-beta levels pre- or post-RT. And there was no difference in pre-RT level of IL-6 between the two groups, but post-RT level of IL-6 was higher in RP group than in non-RP group, P>0.05. ACE level was lower in RP group than in non-RP group both pre- and post-RT, P=0.02 and 0.05 respectively. The incidence of RP was a little higher in those with increased TGF-beta or IL-6 level post-RT. The incidence of RP was a little higher in those whose TGF-beta level or IL-6 level was increased post-RT, but the difference was not significant. Conclusion: This study suggested that ACE level before and during radiotherapy is a promising parameter to predict radiation pneumonitis. The predictive value of TGF-beta and IL-6 for...