Berman Abigail T, Turowski Jason, Mick Rosemarie, Cengel Keith, Farnese Nicole, Basel-Brown Lisa, Mesaros Clementina, Blair Ian, Lawson James, Christofidou-Solomidou Melpo, Lee James, Rengan Ramesh
Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA.
Department of Medicine, Pulmonary Allergy and Critical Care Division, University of Pennsylvania, Philadelphia, USA.
J Pulm Respir Med. 2013 Aug 30;3(4):154. doi: 10.4172/2161-105X.1000154.
The standard of care in Locally-Advanced Non-Small Cell Lung Cancer (LA-NSCLC) is chemotherapy and radiation; however, Radiation-Induced Lung Injury (RILI), which may be prevented by the anti-inflammatory and anti-oxidant properties of Flaxseed (FS), impedes its maximum benefit.
Patients with LA-NSCLC requiring definitive RT were randomized to one FS or control muffin daily from start to 2 weeks after RT. Blood and urine were collected to quantify plasma FS metabolites, Enterodione (ED) and Enterolactone (EL), and urinary oxidative stress biomarkers, 8, 12-iso-iPF2a-VI (isoprostane) and 8-oxo-7,8-dihydro-2'deoxyguanosine (8-oxo-dGuo). Tolerability was defined as consuming ≥ 75% of the intended muffins and no ≥ grade 3 gastrointestinal toxicities.
Fourteen patients (control,7; FS,7) were enrolled. The tolerability rates were 42.9 versus 71.4% (p=0.59) for FS and control, respectively. Mean percentages of intended number of muffins consumed were 37% versus 73% (p=0.12). ED and EL increased at onset of FS and decreased with discontinuation, confirming bioavailability. Isoprostane and 8-oxo-dGuo were detectable. There was a trend towards decreased rates of pneumonitis in FS.
This is the first study to report FS bioavailability and quantify oxidative stress markers in NSCLC patients. FS in the administered muffin formulation did not meet tolerability criteria. Given the promising mechanism of FS as a radioprotectant, further investigations should focus on the optimal method for administration of FS.
局部晚期非小细胞肺癌（LA-NSCLC）的标准治疗方法是化疗和放疗；然而，辐射诱发的肺损伤（RILI）会阻碍其最大获益，而亚麻籽（FS）的抗炎和抗氧化特性或许可以预防这种损伤。
需要进行根治性放疗的LA-NSCLC患者被随机分为两组，从放疗开始至放疗后2周，一组每天食用一个FS松饼，另一组食用对照松饼。采集血液和尿液样本，以定量血浆FS代谢产物肠内二酮（ED）和肠内酯（EL），以及尿液氧化应激生物标志物8,12-异前列腺素F2α-VI（异前列腺素）和8-氧代-7,8-二氢-2'-脱氧鸟苷（8-氧代-dGuo）。耐受性定义为食用松饼数量≥预期数量的75%且无≥3级胃肠道毒性反应。
共纳入14例患者（对照组7例；FS组7例）。FS组和对照组的耐受性分别为42.9%和71.4%（p = 0.59）。食用松饼预期数量的平均百分比分别为37%和73%（p = 0.12）。ED和EL在开始食用FS时升高，停用后下降，证实了其生物利用度。可检测到异前列腺素和8-氧代-dGuo。FS组肺炎发生率有下降趋势。
这是第一项报告NSCLC患者FS生物利用度并定量氧化应激标志物的研究。所使用的松饼配方中的FS未达到耐受性标准。鉴于FS作为辐射防护剂的机制很有前景，进一步研究应聚焦于FS的最佳给药方法。
