Predicting Effect Of Plasma Levels Of ACE,KL-6,bFGF In Radiation Pneumonitis

[Objective] The contents of angiotensin converting enzyme (ACE), krebs von denlungen-6 (KL-6) and basic fibroblast growth factor (bFGF) in plasma of radiation pneumonitis (RP) were measured in order to provide new method for predicting clinical occurrence, diagnose and therapeutic methods of RP.[Materials and Method] 48 cases (males 40 and female 8) with lung cancer, average age is 60 (40-81), who were at one time cured with or without chemotherapy, were treated with radiotherapy. Blood sample were collected and frozen before and after 45-55Gy irradiation. ACE, KL-6, and bFGF contents were measured with enzyme-linked immunosorbent assay (ELISA) methods. RP was graded according to RTOG (Radiation Therapy Oncology Group) acute radiationpulmonary criteria. Grade 2 or worse radiation pulmonary was used as end point.[Results] Plasma bFGF level of RP group (n=15) was 7.42±1.2 ng/ml inpre-radiotherapy and 6.76±0.89 ng/ml in post-radiotherapy. Plasma bFGF levels of non-RP group (n=33) was 7.82±0.9 ng/ml in pre-radiotherapy and 6.00±0.67ng/ml in post-radiotherapy. The bFGF level of RP group was not different from non-RP group (P>0.05) compared respectively with pre- and post-radiotherapy. Plasma KL-6 level of RP group in post-radiotherapy increased 732.64±46.25IU/ml than that in pre-radiotherapy (536.57±57.21 IU/ml, P<0.05). Plasma KL-6 level (584.87±34.23 IU/ml) of non-RP group in pre-radiotherapy was not different from that (597.62±26.34 IU/ml) in post-radiotherapy (P>0.05). Plasma ACE level of RP group in pre-radiotherapy and post-radiotherapy respectively was 367.17±45.23 ng/ml and 385.52±40.68 ng/ml. However, ACE level of non-RP group in pre-radiotherapy and post-radiotherapy respectively was 525.17±52.36 ng/ml and 505.18±55.69 ng/ml. The date indicated ACE content in RP significantly decreased than that in non-RP (P<0.05) patients.[ Conclusion ] The occurrence of radiation pneumonitis does not closely correlated to patient's sex, age, location of tumor, KPS, history of smoking. The occurrence of RP does not lie on therapeutic methods such as operation, chemotherapy, radiochemotherapeutic sequence. The data suggest the measure of plasma ACE and KL-6 content is a promising parameter to predict radiation pneumonia. The predicting value of bFGF for radiation pneumonia is weak.