Variations of circulating endothelial progenitor cells and transforming growth factor-beta-1 (TGF-β1) during thoracic radiotherapy are predictive for radiation pneumonitis

Radiation Oncology

Huiming Yu³  Xuan Wang⁴  Luhua Zhang²  Yongjie Zhong²  Wenjun Zhang²  Tingyi Xia⁴  Yunfang Liu¹ 

[1] Department of Diagnosis, Shandong University Medical School, Jinan, Shandong Province 250012, China;Department of Radiotherapy, Capital Medical University Affiliated Beijing Chao- yang Hospital, Beijing 100020, China;Present address: Huiming Yu, Department of Radiotherapy, Capital Medical University Affiliated Beijing Chao-yang Hospital, No. 8, Gongti South Road, Beijing 100020, P.R. China;Cancer Center, Air Force General Hospital, PLA, Beijing 100012, China

关键词: Endothelial progenitor cells;    Transforming growth factor-beta-1;    Radiation pneumonitis;    Non-small cell lung cancer;   

Others  :  1153325
DOI  :  10.1186/1748-717X-8-189

 received in 2013-03-16, accepted in 2013-06-14,  发布年份 2013

【 摘 要 】

Background

The vascular endothelial cells are important targets of radiotherapy, which may be involved in the pathogenesis of radiation pneumonitis (RP). This study investigated the variations of circulating endothelial progenitor cells (EPCs) and transforming growth factor-beta-1 (TGF-β1) during three-dimensional conformal radiation therapy (3D-CRT) in patients with non–small-cell lung cancer (NSCLC) and analyzed the correlation between these variations with the occurrence of RP.

Patients and methods

From November 2008 to November 2009, eighty-four consecutive patients receiving 3D-CRT for stage III disease were evaluated prospectively. Circulating EPCs and TGF-β1 levels were measured at baseline, every 2 weeks during, and at the end of treatment. RP was evaluated prospectively at 6 weeks after 3D-CRT.

Results

Thirty-eight patients (47.5%) experienced score 1 or more of RP. The baseline levels of EPCs and TGF-β1 were analyzed, no difference was found between patients with and without RP during and after 3D-CRT. By serial measurement of TGF-β1 and EPCs levels, we found that the mean levels of EPCs in the whole population remained stable during radiotherapy, but the mean levels of TGF-β1 increased slowly during radiotherapy. TGF-β1 and EPCs levels were all significantly higher at week 2, week 4 and week 6 in patients with RP than that in patients without RP, respectively. During the period of radiation treatment, TGF-β1 levels began to increase in the first 2 weeks and became significantly higher at week 6 (P < 0.01). EPCs levels also began to increase in the first 2 weeks and reached a peak at week 4. Using an ANOVA model for repeated-measures, we found significant associations between the levels of TGF-β1 and EPCs during the course of 3D-CRT and the risk of developing RP (P < 0.01). Most of the dosimetric factors showed a significant association with RP.

Conclusion

Early variations of TGF-β1 and EPCs levels during 3D-CRT are significantly associated with the risk of RP. Variations of circulating TGF-β1 and EPCs levels during 3D-CRT may serve as independent predictive factors for RP.

Trial registration

Trials registration number: 20070618

【 授权许可】

   
2013 Liu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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