Hara Ryusuke, Itami Jun, Komiyama Takafumi, Katoh Daiki, Kondo Tatsuya
Department of Radiation Therapy and Oncology, International Medical Center of Japan, Tokyo, Japan.
Chest. 2004 Jan;125(1):340-4. doi: 10.1378/chest.125.1.340.
To determine the usefulness of serum KL-6 levels for predicting the occurrence of radiation pneumonitis (RP) after the application of single high-dose stereotactic radiation therapy for lung tumors, the serum KL-6 levels were measured in 16 patients before irradiation and every 1 or 2 months thereafter. Three of the 16 patients experienced RP of grade 3 severity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group toxicity criteria. RP occurred 3 months after the completion of radiation therapy in two patients, and 4 months after completion in one patient. RP occurred at significantly increased frequencies in patients with primary lung cancer (p = 0.01) and adenocarcinoma (p = 0.01), and in those undergoing the concurrent irinotecan therapy (p = 0.02). In all 16 patients, the lactate dehydrogenase level remained normal during the follow-up period. In all three of the patients with RP, KL-6 levels increased by > 1.5-fold compared to the pretreatment value and over the cutoff level of 500 IU. The ratio of the increase in serum KL-6 values 2 months after the patient had undergone irradiation showed a significant correlation with the occurrence of RP (p = 0.04). In conclusion, KL-6 is a useful marker for prediction of the occurrence of RP after single, fractional, high-dose stereotactic irradiation of lung tumors.
为了确定血清KL-6水平在预测单次大剂量立体定向放射治疗肺部肿瘤后放射性肺炎（RP）发生方面的作用，对16例患者在放疗前及放疗后每1或2个月检测血清KL-6水平。根据欧洲癌症研究与治疗组织/放射治疗肿瘤学组的毒性标准，16例患者中有3例发生了3级严重程度的RP。2例患者在放疗结束后3个月发生RP，1例在放疗结束后4个月发生RP。原发性肺癌患者（p = 0.01）、腺癌患者（p = 0.01）以及接受伊立替康同步治疗的患者（p = 0.02）发生RP的频率显著增加。在所有16例患者中，随访期间乳酸脱氢酶水平均保持正常。在所有3例发生RP的患者中，KL-6水平较治疗前值升高超过1.5倍且超过了500 IU的临界值。患者放疗后2个月血清KL-6值的升高比例与RP的发生显著相关（p = 0.04）。总之，KL-6是预测单次、分次、大剂量立体定向照射肺部肿瘤后RP发生的有用标志物。
