State Key Laboratory of Molecular Oncology, Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Radiation Oncology, GRU Cancer Center and Medical College of Georgia, Augusta, GA, United States.
Department of Radiation Oncology, GRU Cancer Center and Medical College of Georgia, Augusta, GA, United States.
Radiother Oncol. 2018 Mar;126(3):506-510. doi: 10.1016/j.radonc.2017.12.026.
To study whether cytokine markers may improve predictive accuracy of radiation esophagitis (RE) in non-small cell lung cancer (NSCLC) patients.
A total of 129 patients with stage I-III NSCLC treated with radiotherapy (RT) from prospective studies were included. Thirty inflammatory cytokines were measured in platelet-poor plasma samples. Logistic regression was performed to evaluate the risk factors of RE. Stepwise Akaike information criterion (AIC) and likelihood ratio test were used to assess model predictions.
Forty-nine of 129 patients (38.0%) developed grade ≥2 RE. Univariate analysis showed that age, stage, concurrent chemotherapy, and eight dosimetric parameters were significantly associated with grade ≥2 RE (p < 0.05). IL-4, IL-5, IL-8, IL-13, IL-15, IL-1α, TGFα and eotaxin were also associated with grade ≥2 RE (p < 0.1). Age, esophagus generalized equivalent uniform dose (EUD), and baseline IL-8 were independently associated grade ≥2 RE. The combination of these three factors had significantly higher predictive power than any single factor alone. Addition of IL-8 to toxicity model significantly improves RE predictive accuracy (p = 0.019).
Combining baseline level of IL-8, age and esophagus EUD may predict RE more accurately. Refinement of this model with larger sample sizes and validation from multicenter database are warranted.
研究细胞因子标志物是否能提高非小细胞肺癌（NSCLC）患者放射性食管炎（RE）的预测准确性。
纳入了来自前瞻性研究的 129 例 I-III 期 NSCLC 患者，他们接受了放疗（RT）。在血小板贫乏的血浆样本中测量了 30 种炎症细胞因子。采用逻辑回归来评估 RE 的危险因素。逐步 Akaike 信息准则（AIC）和似然比检验用于评估模型预测。
129 例患者中有 49 例（38.0%）发生了≥2 级 RE。单因素分析表明，年龄、分期、同期化疗和 8 个剂量学参数与≥2 级 RE 显著相关（p<0.05）。IL-4、IL-5、IL-8、IL-13、IL-15、IL-1α、TGFα 和嗜酸性粒细胞趋化因子也与≥2 级 RE 相关（p<0.1）。年龄、食管均匀剂量（EUD）和基线 IL-8 与≥2 级 RE 独立相关。这三个因素的组合比任何单一因素的预测能力都显著更高。将 IL-8 添加到毒性模型中显著提高了 RE 预测准确性（p=0.019）。
结合基线 IL-8、年龄和食管 EUD 水平可能更准确地预测 RE。需要用更大的样本量和多中心数据库来验证和完善该模型。
