Lopez Guerra Jose Luis, Song Yi-Peng, Nguyen Quynh-Nhu, Gomez Daniel R, Liao Zhongxing, Xu Ting
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Radiation Oncology, Virgen del Rocío University Hospital, Seville 41013, Spain.
Chronic Dis Transl Med. 2018 Mar 16;4(1):59-66. doi: 10.1016/j.cdtm.2018.02.006. eCollection 2018 Mar.
Single-nucleotide polymorphisms (SNPs) in the ataxia telangiectasia-mutated gene have been linked with pneumonitis after radiotherapy for lung cancer but have not been evaluated in terms of pulmonary function impairment. Here we investigated potential associations between SNPs in and changes in diffusing capacity of the lung for carbon monoxide (DLCO) in patients with non-small-cell lung cancer (NSCLC) after radiotherapy.
From November 1998 through June 2009, 448 consecutive patients with inoperable primary NSCLC underwent definitive (≥60 Gy) radiotherapy, with or without chemotherapy. After excluding patients with a history of thoracic surgery, radiation, or lung cancer; without DNA samples available for analysis; or without pulmonary function testing within the 12 months before and the 12 months after radiotherapy, 100 patients were identified who are the subjects of this study. We genotyped two SNPs of previously found to be associated with radiation-induced pneumonitis (rs189037 and rs228590) and evaluated potential correlations between these SNPs and impairment (decreases) in DLCO by using logistic regression analysis.
Univariate and multivariate analyses showed that the AA genotype of rs189037 was associated with decreased DLCO after definitive radiotherapy than the GG/AG genotypes [univariate coefficient, -0.122; 95% confidence interval (), -0.236 to -0.008; = 0.037; and multivariate coefficient, -0.102; 95% , -0.198 to -0.005; = 0.038]. No such correlations were found for rs228590 (univariate coefficient, -0.096; 95% , -0.208 to 0.017; = 0.096).
The AA genotype of rs189037 was associated with higher risk of lung injury than were the GG/AG genotypes in patients with NSCLC treated with radiotherapy. This finding should be validated prospectively with other patient populations.
共济失调毛细血管扩张突变基因中的单核苷酸多态性(SNP)已被证明与肺癌放疗后的肺炎有关,但尚未在肺功能损害方面进行评估。在此,我们研究了非小细胞肺癌(NSCLC)患者放疗后共济失调毛细血管扩张突变基因中的SNP与一氧化碳肺弥散量(DLCO)变化之间的潜在关联。
从1998年11月至2009年6月,448例连续的无法手术切除的原发性NSCLC患者接受了根治性(≥60 Gy)放疗,部分患者接受了化疗。排除有胸外科手术、放疗或肺癌病史的患者;没有可供分析的DNA样本的患者;或在放疗前12个月和放疗后12个月内未进行肺功能测试的患者后,确定了100例患者作为本研究对象。我们对先前发现与放射性肺炎相关的两个共济失调毛细血管扩张突变基因SNP(rs189037和rs228590)进行基因分型,并通过逻辑回归分析评估这些SNP与DLCO损害(降低)之间的潜在相关性。
单因素和多因素分析显示,与GG/AG基因型相比,共济失调毛细血管扩张突变基因rs189037的AA基因型在根治性放疗后与DLCO降低相关[单因素系数,-0.122;95%置信区间(CI),-0.236至-0.008;P = 0.037;多因素系数,-0.102;95%CI,-0.198至-0.005;P = 0.038]。未发现rs228590有此类相关性(单因素系数,-0.096;95%CI,-0.208至0.017;P = 0.096)。
在接受放疗的NSCLC患者中,共济失调毛细血管扩张突变基因rs189037的AA基因型比GG/AG基因型与更高的肺损伤风险相关。这一发现应在前瞻性研究中与其他患者群体进行验证。