Can exhaled NO fraction predict radiotherapy-induced lung toxicity in lung cancer patients?

Enache, Irina; Noël, G.; Jeung, M-Young; Meyer, Nicolás; Oswald‐Mammosser, Monique; Urban-Kraemer, Emile; Schumacher, C.; Gény, Bernard; Quoix, Élisabeth; Charloux, Anne

doi:10.1186/1748-717x-7-117

Cited by 9 publications

(15 citation statements)

References 25 publications

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“…We previously reported that subsequent to RT or combined chemo-RT in 29 patients, the eNO level had decreased by 35% immediately subsequent to the completion of 40 Gy RT (6). The decrease in the eNO level observed following the treatment of chest malignancies is caused by cell death in the tumor and the surrounding tissues; this may also be accompanied by a reduction in tumor-associated inflammation, including cytokine production (17). The present study confirmed our previous data, demonstrating that RT reduced the levels of eNO.…”

Section: Discussionmentioning

confidence: 99%

Measurement of exhaled nitric oxide and serum surfactant protein D levels for monitoring radiation pneumonitis following thoracic radiotherapy

et al. 2017

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The present study aimed to examine the role of exhaled nitric oxide (eNO) and serum surfactant protein D (SP-D) level in the determination of radiation pneumonitis (RP) after thoracic radiotherapy (RT). The study included 34 treatments for 33 patients, including 16 three-dimensional conformal and 18 stereotactic body RT treatments. eNO levels were measured prior to RT, immediately subsequent to RT, every week during the RT course and at 1, 3, 6, 9 and 12 months following the treatment. The therapy reduced the eNO from 24.3±12.8 ppb prior to RT to 19.0±10.4 ppb immediately subsequent to RT (P=0.04). A total of 5 patients (14%) developed symptomatic RP of grade 2 or higher 3–5 months later, and exhibited an eNO elevation of 2.1±0.68-fold the minimum value, whereas the RP- group exhibited 1.4±0.6-fold elevation (P=0.02). The sensitivity of a cut-off of a 1.4-fold increase in the eNO ratio at the onset of RP was 100%; however, the specificity was 52%, and no predictive alterations to eNO levels were observed prior to the onset of RP. RT was associated with an elevated serum SP-D level at 3–6 months after RT. There was a statistically significant difference in the initial serum SP-D level between RP+ and RP- patients. In conclusion, obtaining the eNO ratio was a useful RP monitoring tool but did not predict RP occurrence in the present setting, whereas serum SP-D level may be a potential predictor for the detection of RP risk.

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Section: Discussionmentioning

confidence: 99%

Measurement of exhaled nitric oxide and serum surfactant protein D levels for monitoring radiation pneumonitis following thoracic radiotherapy

et al. 2017

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“…In this study, the patients were divided: the symptomatic RP group (SRP, with the CTCAE v4.0 score ≥ grade 2) and the asymptomatic RP group (ASRP, with CTCAE v4.0 score as grade 0 or 1) [13]. …”

Section: Methodsmentioning

confidence: 99%

Exhaled Nitric Oxide Is Useful in Symptomatic Radioactive Pneumonia: A Retrospective Study

Fei

2017

Mediators of Inflammation

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The aim was to defect the exhaled nitric oxide (eNO) prediction value of symptomatic radioactive pneumonia (SRP). 64 cases of lung cancer or esophagus cancer, who had the primary radiotherapy (intensity-modulated radiation therapy), were included from 2015 June to 2016 January. During the following, the patients were divided: the symptomatic radiation pneumonia group (SRP, with the CTCAE v4.0 score > 2) and the asymptomatic radiation pneumonia group (ASRP, with CTCAE v4.0 score ≤ 1). All the patients were measured eNO before and at the end of thoracic radiotherapy and gain the posttherapy eNO value and the eNO ratio (posttherapy eNO value/pretherapy eNO value), then the predictive values of eNO toward SRP were measured using the receiver-operating characteristic (ROC). 17 cases were included in the SRP group and the other 47 were included in the ASRP group. The posttherapy eNO was 29.35 (19~60) bbp versus 20.646 (11~37) (P < 0 001), and the ratio was 1.669 (0.61~3.5) versus 0.920 (0.35~1.5) (P < 0 01) (symptomatic versus asymptomatic). ROC showed that the cutoff value of SRP was 19.5 bbp (posttherapy eNO, area under concentration-time curve (AUC) = 0.879) and 1.305 (eNO ratio, AUC = 0.774), which meant that posttherapy eNO and eNO ratio were useful in finding SRP.

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“…Some recent studies revealed reduction of mutated KRAS oncogene in EBC [40] and some VOCs in exhaled breath [41] after surgical resection of pulmonary tumor, particularly nonsmall cell type. Unfortunately, a recent study demonstrated that serial FE NO measurements during radiotherapy in patients with pulmonary cancer had a low ability to detect symptomatic radiation pneumonitis [42]. …”

Section: Exhaled Markers In Pulmonary Cancermentioning

confidence: 99%

Breath Tests in Respiratory and Critical Care Medicine: From Research to Practice in Current Perspectives

Cheepsattayakorn

2013

BioMed Research International

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Today, exhaled nitric oxide has been studied the most, and most researches have now focusd on asthma. More than a thousand different volatile organic compounds have been observed in low concentrations in normal human breath. Alkanes and methylalkanes, the majority of breath volatile organic compounds, have been increasingly used by physicians as a novel method to diagnose many diseases without discomforts of invasive procedures. None of the individual exhaled volatile organic compound alone is specific for disease. Exhaled breath analysis techniques may be available to diagnose and monitor the diseases in home setting when their sensitivity and specificity are improved in the future.

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Can exhaled NO fraction predict radiotherapy-induced lung toxicity in lung cancer patients?

Cited by 9 publications

References 25 publications

Measurement of exhaled nitric oxide and serum surfactant protein D levels for monitoring radiation pneumonitis following thoracic radiotherapy

Measurement of exhaled nitric oxide and serum surfactant protein D levels for monitoring radiation pneumonitis following thoracic radiotherapy

Exhaled Nitric Oxide Is Useful in Symptomatic Radioactive Pneumonia: A Retrospective Study

Breath Tests in Respiratory and Critical Care Medicine: From Research to Practice in Current Perspectives

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