A Correlation Study Of Plasma TNF-α、TGF-β、Il-6Levels And Dose-volume Parameters To Radiation Induced Lung Injury

Objective: The purpose of the current study, based on the correlation between thelevel of plasma tumor necrosis factor-α（TNF-α）, transform growth factor beta (TGF-β),interleukin-6(IL-6), DVH and radiation induced lung injury (RILI), was to predict thevalue of plasma TNF-α、TGF-β、IL-6levels and dose-volume parameters in RILI。Methods:140thoracic neoplasm patients, which were treated with intensity modulatedradiation therapy, were retrospectively collected and analyzed. Enzyme-linkedimmunosorbent assay (ELISA) was utilized to detect the levels of plasma TNF-α, TGF-βand IL-6in patients before radiotherapy (pre-RT) and when radiotherapy does reached45-50Gy (during-RT). DVH parameters include V5, V10, V20, V30, V40and MLD.According to the RTOG morbidity scoring classification, radiation pneumonitis wasclassified. Either Grade1or more RILI was taken as the main end point. Results:35of140patients had RILI, in which10were grade1RILI，18were grade2RILI and7weregrade3RILI,the incidence of RILI was25％.The levels of plasma TNF-α, TGF-β andIL-6were significantly difference between pre-RT and during-RT group(P＜0.001).Univariate analysis demonstrated that the RILI incidence was associated with pre-RTlevels of plasma TNF-α, V5, V10, V20, V30, V40, MLD, the function of lung pre-RT,types of disease and clinical stages (P＜0.05). Multivariate analysis showed that pre-RThigher levels of plasma IL-6, V20≥25%and lung cancer were independently associatedwith RILI (OR=1.024,3.466,3.971,P＜0.05).Conclusions: These results indicated thatsuch factors, pre-RT higher levels of plasma IL-6, V20≥25%and lung cancer were foundto confer significantly increased risk of the RILI, which could serve as the guidance ofclinical treatment.