Elevation of Plasma TGF-β1 During Radiation Therapy Predicts Radiation-Induced Lung Toxicity in Patients With Non-Small-Cell Lung Cancer: A Combined Analysis From Beijing and Michigan

Lujun Zhao, Luhua Wang, Wei Ji, Xiaozhen Wang, Xiangzhi Zhu, James A. Hayman, Gregory P. Kalemkerian, Weizhi Yang, Dean Brenner, Theodore S. Lawrence, Feng Ming Kong

Research output: Contribution to journalArticle

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Abstract

Purpose: To test whether radiation-induced elevations of transforming growth factor-β1 (TGF-β1) during radiation therapy (RT) correlate with radiation-induced lung toxicity (RILT) in patients with non-small-cell lung cancer (NSCLC) and to evaluate the ability of mean lung dose (MLD) to improve the predictive power. Methods and Materials: Eligible patients included those with Stage I-III NSCLC treated with RT with or without chemotherapy. Platelet-poor plasma was obtained pre-RT and at 4-5 weeks (40-50 Gy) during RT. TGF-β1 was measured using an enzyme-linked immunosorbent assay. The primary endpoint was ≥ Grade 2 RILT. Mann-Whitney U test, logistic regression, and chi-square were used for statistical analysis. Results: A total of 165 patients were enrolled in this study. The median radiation dose was 60 Gy, and the median MLD was 15.3 Gy. Twenty-nine patients (17.6%) experienced RILT. The incidence of RILT was 46.2% in patients with a TGF-β1 ratio > 1 vs. 7.9% in patients with a TGF-β1 ratio ≤ 1 (p < 0.001), and it was 42.9% if MLD > 20 Gy vs. 17.4% if MLD ≤ 20 Gy (p = 0.024). The incidence was 4.3% in patients with a TGF-β1 ratio ≤ 1 and MLD ≤ 20 Gy, 47.4% in those with a TGF-β1 ratio >1 or MLD > 20 Gy, and 66.7% in those with a TGF-β1 ratio >1 and MLD > 20 Gy (p < 0.001). Conclusions: Radiation-induced elevation of plasma TGF-β1 level during RT is predictive of RILT. The combination of TGF- β1 and MLD may help stratify the patients for their risk of RILT.

Original languageEnglish (US)
Pages (from-to)1385-1390
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume74
Issue number5
DOIs
StatePublished - Aug 1 2009

Fingerprint

Transforming Growth Factors
Non-Small Cell Lung Carcinoma
toxicity
lungs
radiation therapy
Radiotherapy
cancer
Radiation
Lung
radiation
dosage
Beijing
incidence
Radiation Dosage
Incidence
Nonparametric Statistics
logistics
chemotherapy
platelets
statistical analysis

Keywords

  • Mean lung dose
  • Non-small-cell lung cancer
  • Radiation-induced lung toxicity
  • Transforming growth factor β1

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Elevation of Plasma TGF-β1 During Radiation Therapy Predicts Radiation-Induced Lung Toxicity in Patients With Non-Small-Cell Lung Cancer : A Combined Analysis From Beijing and Michigan. / Zhao, Lujun; Wang, Luhua; Ji, Wei; Wang, Xiaozhen; Zhu, Xiangzhi; Hayman, James A.; Kalemkerian, Gregory P.; Yang, Weizhi; Brenner, Dean; Lawrence, Theodore S.; Kong, Feng Ming.

In: International Journal of Radiation Oncology Biology Physics, Vol. 74, No. 5, 01.08.2009, p. 1385-1390.

Research output: Contribution to journalArticle

Zhao, Lujun ; Wang, Luhua ; Ji, Wei ; Wang, Xiaozhen ; Zhu, Xiangzhi ; Hayman, James A. ; Kalemkerian, Gregory P. ; Yang, Weizhi ; Brenner, Dean ; Lawrence, Theodore S. ; Kong, Feng Ming. / Elevation of Plasma TGF-β1 During Radiation Therapy Predicts Radiation-Induced Lung Toxicity in Patients With Non-Small-Cell Lung Cancer : A Combined Analysis From Beijing and Michigan. In: International Journal of Radiation Oncology Biology Physics. 2009 ; Vol. 74, No. 5. pp. 1385-1390.
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abstract = "Purpose: To test whether radiation-induced elevations of transforming growth factor-β1 (TGF-β1) during radiation therapy (RT) correlate with radiation-induced lung toxicity (RILT) in patients with non-small-cell lung cancer (NSCLC) and to evaluate the ability of mean lung dose (MLD) to improve the predictive power. Methods and Materials: Eligible patients included those with Stage I-III NSCLC treated with RT with or without chemotherapy. Platelet-poor plasma was obtained pre-RT and at 4-5 weeks (40-50 Gy) during RT. TGF-β1 was measured using an enzyme-linked immunosorbent assay. The primary endpoint was ≥ Grade 2 RILT. Mann-Whitney U test, logistic regression, and chi-square were used for statistical analysis. Results: A total of 165 patients were enrolled in this study. The median radiation dose was 60 Gy, and the median MLD was 15.3 Gy. Twenty-nine patients (17.6{\%}) experienced RILT. The incidence of RILT was 46.2{\%} in patients with a TGF-β1 ratio > 1 vs. 7.9{\%} in patients with a TGF-β1 ratio ≤ 1 (p < 0.001), and it was 42.9{\%} if MLD > 20 Gy vs. 17.4{\%} if MLD ≤ 20 Gy (p = 0.024). The incidence was 4.3{\%} in patients with a TGF-β1 ratio ≤ 1 and MLD ≤ 20 Gy, 47.4{\%} in those with a TGF-β1 ratio >1 or MLD > 20 Gy, and 66.7{\%} in those with a TGF-β1 ratio >1 and MLD > 20 Gy (p < 0.001). Conclusions: Radiation-induced elevation of plasma TGF-β1 level during RT is predictive of RILT. The combination of TGF- β1 and MLD may help stratify the patients for their risk of RILT.",
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author = "Lujun Zhao and Luhua Wang and Wei Ji and Xiaozhen Wang and Xiangzhi Zhu and Hayman, {James A.} and Kalemkerian, {Gregory P.} and Weizhi Yang and Dean Brenner and Lawrence, {Theodore S.} and Kong, {Feng Ming}",
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T2 - A Combined Analysis From Beijing and Michigan

AU - Zhao, Lujun

AU - Wang, Luhua

AU - Ji, Wei

AU - Wang, Xiaozhen

AU - Zhu, Xiangzhi

AU - Hayman, James A.

AU - Kalemkerian, Gregory P.

AU - Yang, Weizhi

AU - Brenner, Dean

AU - Lawrence, Theodore S.

AU - Kong, Feng Ming

PY - 2009/8/1

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N2 - Purpose: To test whether radiation-induced elevations of transforming growth factor-β1 (TGF-β1) during radiation therapy (RT) correlate with radiation-induced lung toxicity (RILT) in patients with non-small-cell lung cancer (NSCLC) and to evaluate the ability of mean lung dose (MLD) to improve the predictive power. Methods and Materials: Eligible patients included those with Stage I-III NSCLC treated with RT with or without chemotherapy. Platelet-poor plasma was obtained pre-RT and at 4-5 weeks (40-50 Gy) during RT. TGF-β1 was measured using an enzyme-linked immunosorbent assay. The primary endpoint was ≥ Grade 2 RILT. Mann-Whitney U test, logistic regression, and chi-square were used for statistical analysis. Results: A total of 165 patients were enrolled in this study. The median radiation dose was 60 Gy, and the median MLD was 15.3 Gy. Twenty-nine patients (17.6%) experienced RILT. The incidence of RILT was 46.2% in patients with a TGF-β1 ratio > 1 vs. 7.9% in patients with a TGF-β1 ratio ≤ 1 (p < 0.001), and it was 42.9% if MLD > 20 Gy vs. 17.4% if MLD ≤ 20 Gy (p = 0.024). The incidence was 4.3% in patients with a TGF-β1 ratio ≤ 1 and MLD ≤ 20 Gy, 47.4% in those with a TGF-β1 ratio >1 or MLD > 20 Gy, and 66.7% in those with a TGF-β1 ratio >1 and MLD > 20 Gy (p < 0.001). Conclusions: Radiation-induced elevation of plasma TGF-β1 level during RT is predictive of RILT. The combination of TGF- β1 and MLD may help stratify the patients for their risk of RILT.

AB - Purpose: To test whether radiation-induced elevations of transforming growth factor-β1 (TGF-β1) during radiation therapy (RT) correlate with radiation-induced lung toxicity (RILT) in patients with non-small-cell lung cancer (NSCLC) and to evaluate the ability of mean lung dose (MLD) to improve the predictive power. Methods and Materials: Eligible patients included those with Stage I-III NSCLC treated with RT with or without chemotherapy. Platelet-poor plasma was obtained pre-RT and at 4-5 weeks (40-50 Gy) during RT. TGF-β1 was measured using an enzyme-linked immunosorbent assay. The primary endpoint was ≥ Grade 2 RILT. Mann-Whitney U test, logistic regression, and chi-square were used for statistical analysis. Results: A total of 165 patients were enrolled in this study. The median radiation dose was 60 Gy, and the median MLD was 15.3 Gy. Twenty-nine patients (17.6%) experienced RILT. The incidence of RILT was 46.2% in patients with a TGF-β1 ratio > 1 vs. 7.9% in patients with a TGF-β1 ratio ≤ 1 (p < 0.001), and it was 42.9% if MLD > 20 Gy vs. 17.4% if MLD ≤ 20 Gy (p = 0.024). The incidence was 4.3% in patients with a TGF-β1 ratio ≤ 1 and MLD ≤ 20 Gy, 47.4% in those with a TGF-β1 ratio >1 or MLD > 20 Gy, and 66.7% in those with a TGF-β1 ratio >1 and MLD > 20 Gy (p < 0.001). Conclusions: Radiation-induced elevation of plasma TGF-β1 level during RT is predictive of RILT. The combination of TGF- β1 and MLD may help stratify the patients for their risk of RILT.

KW - Mean lung dose

KW - Non-small-cell lung cancer

KW - Radiation-induced lung toxicity

KW - Transforming growth factor β1

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