&lt;p&gt;Dynamic changes in T-cell subsets and C-reactive protein after radiation therapy in lung cancer patients and correlation with symptomatic radiation pneumonitis treated with steroid therapy&lt;/p&gt;

Bai, Linquan; Zhou, Baosen; Zhao, Yong

doi:10.2147/cmar.s209286

Cited by 8 publications

(7 citation statements)

References 32 publications

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“…The tumor of patients with middle or late EC is large, so the postoperative effect is inconsistent due to the difference of their tumor location or tumor size, and prophylactic radiotherapy can further kill the residual tumor, which may be one major reason for the efficacy improvement by prophylactic radiotherapy. We quantified CRP and WBC in the two groups and found after therapy that both groups showed notably increased CRP and WBC, but the levels were not considerably different in both groups, which were in line with results discovered previously [ 19 ]. We reason that for patients with EC, after surgery or postoperative radiotherapy, their body will produce stress response and their CRP and WBC will increase.…”

Section: Discussionsupporting

confidence: 90%

Effect of Prophylactic Radiotherapy on Patients with Stage II-III Esophageal Cancer after Esophageal Cancer Radical Operation and Influencing Factors in Its Recurrence

Guo

Kang

2021

Journal of Oncology

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Objective. To explore the effect of prophylactic radiotherapy on patients with stage II-III esophageal cancer (EC) after esophageal cancer radical operation (ECRO) and influencing factors on EC recurrence. Methods. Totally, 65 patients with EC in our hospital were enrolled. Among them, 30 patients were treated by routine ECRO as a control group (Con group) and 35 patients by prophylactic radiotherapy as a research group (Res group). Then, the following measures were taken: record the efficacy on both groups, quantify their C-reactive protein (CRP) and white blood cell count (WBC) before and after therapy, evaluate their mental state through the revised piper fatigue scale (PFS-R) before and after therapy, determine their changes in Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after therapy, compare them in terms of lymph-node metastatic rate (LNMR), hematogenous metastasis rate (HMR), anastomotic recurrence rate (ARR), and 3-year survival rate, compare them in terms of life quality after therapy via the Quality of Life-Core Questionnaire (QLQ-C30), and analyze influencing factors on their recurrence. Results. The Res group showed a notably higher total effective rate (TER) than the Con group ( P = 0.037 ). After therapy, CRP and WBC in both groups increased, but their levels were not considerably different in both ( P > 0.05 ). Additionally, after therapy, in contrast to the Con group, the Res group got notably lower PFS-R, SDS, and SAS scores, showed notably lower LNMR and ARR and notably higher 3-year survival rate, and experienced notably higher life quality (all P < 0.05 ), and the HMR results were not considerably different in both groups ( P > 0.05 ). Moreover, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), esophageal inflammation history, family medical history, postoperative complications, and lymphatic and vascular infiltration were risk factors for the disease recurrence, and treatment method was the protective factor for it. Conclusion. For patients with stage II-III EC after ECRO, prophylactic radiotherapy is highly effective and safe and can lower the recurrence rate, so it is worth popularizing in clinical practice.

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Section: Discussionsupporting

confidence: 90%

Effect of Prophylactic Radiotherapy on Patients with Stage II-III Esophageal Cancer after Esophageal Cancer Radical Operation and Influencing Factors in Its Recurrence

Guo

Kang

2021

Journal of Oncology

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“…Flt-3 ligand is a known biomarker of hematopoietic injury (Kumar et al, 2018), expression of which was abrogated by GT3. Inflammatory biomarker C-reactive protein (CRP) has also been shown to be an effective indicator of possible radiation pneumonitis in humans (Bai et al, 2019) which was also observed as more than 6 fold increase of the protein in saline treated animals. This increased expression is immediate as of day 1 post-PBI and stayed high even on day 30.…”

Section: Discussionmentioning

confidence: 99%

Gamma Tocotrienol Protects Mice From Targeted Thoracic Radiation Injury

et al. 2020

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Radiation injury will result in multiorgan dysfuntion leading to multiorgan failure. In addition to many factors such as radiation dose, dose rate, the severity of the injury will also depend on organ systems which are exposed. Here, we report the protective property of gamma tocotrienol (GT3) in total as well as partial body irradiation (PBI) model in C3H/HeN male mice. We have carried out PBI by targeting thoracic region (lung-PBI) using Small Animal Radiation Research Platform, an X-ray irradiator with capabilities of an image guided irradiation with a variable collimator with minimized exposure to non-targeted tissues and organs. Precise and accurate irradiation of lungs was carried out at either 14 or 16 Gy at an approximate dose rate of 2.6 Gy/min. Though a low throughput model, it is amenable to change the field size on the spot. No damage to other non-targeted organs was observed in histopathological evaluation. There was no significant change in peripheral blood counts of irradiated mice in comparison to naïve mice. Femoral bone marrow cells had no damage in irradiated mice. As expected, damage to the targeted tissue was observed in the histopathological evaluation and non-targeted tissue was found normal. Regeneration and increase of cellularity and megakaryocytes on GT3 treatment was compared to significant loss of cellularity in saline group. Peak alveolitis was observed on day 14 post-PBI and protection from alveolitis by GT3 was noted. In irradiated lung tissue, thirty proteins were found to be differentially expressed but modulated by GT3 to reverse the effects of irradiation. We propose that possible mode of action of GT3 could be Angiopoietin 2-Tie2 pathway leading to AKT/ERK pathways resulting in disruption in cell survival/angiogenesis.

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“…In a study of advanced NSCLC patients treated with chemotherapy, n = 142 patients considered evaluable for cancer related CRP were suggested to have better prognosis if CRP levels decreased after two cycles of treatment [ 16 ], contrary to our findings for the docetaxel arm ( Table 1 ). One confounding factor may be the steroid pretreatment administered with docetaxel that is known to affect CRP levels [ 17 ]. In contrast, in a small study with n = 31 NSCLC patients treated with pembrolizumab monotherapy, the authors found that serum CRP levels at pre-treatment were not predictive, but increase of serum CRP at 6 weeks after anti-PD-1 therapy was predictive of clinical benefit [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein reduction post treatment is associated with improved survival in atezolizumab (anti-PD-L1) treated non-small cell lung cancer patients

Patil¹,

Zou²,

Mocci³

et al. 2021

PLoS ONE

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Purpose Overall survival (OS) is the most significant endpoint for evaluation of treatment benefit with checkpoint inhibitors (CPI) in cancer. We evaluated serum C-reactive protein (CRP) in non-small cell lung cancer (NSCLC) trials with atezolizumab (anti-PD-L1) as an early OS surrogate. Methods Serum from patients enrolled in randomized Phase II (n = 240) and Phase III (n = 701) trials of NSCLC patients (POPLAR, OAK) who progressed on prior-platinum chemotherapy, were analyzed for CRP levels over time. Patients were grouped by changes in CRP levels post-treatment as either increased (≥ 1.5 fold), decreased (≤ 1.5 fold) or unchanged (within +1.5 fold) relative to pre-treatment levels to assess association with progression free survival (PFS) and OS. Results Decrease in serum CRP levels at 6 weeks relative to pre-treatment were observed in patients with RECIST1.1 based complete or partial responses (CR/PR) to atezolizumab whereas patients with disease progression (PD) demonstrated an increase in CRP levels in the Phase II POPLAR study, and confirmed in the Phase III OAK study. Decrease in serum CRP as early as six weeks post treatment predicted improved PFS and OS, even in patients who were determined as stable disease (SD) in their first scan. This effect was not observed in the chemotherapy arms. Conclusion Modulation of serum CRP correlates with clinical outcome post-atezolizumab treatment. This routine lab test may provide utility in informing OS signals as early as 6 weeks post-initiation of therapy with CPIs in NSCLC.

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<p>Dynamic changes in T-cell subsets and C-reactive protein after radiation therapy in lung cancer patients and correlation with symptomatic radiation pneumonitis treated with steroid therapy</p>

Cited by 8 publications

References 32 publications

Effect of Prophylactic Radiotherapy on Patients with Stage II-III Esophageal Cancer after Esophageal Cancer Radical Operation and Influencing Factors in Its Recurrence

Effect of Prophylactic Radiotherapy on Patients with Stage II-III Esophageal Cancer after Esophageal Cancer Radical Operation and Influencing Factors in Its Recurrence

Gamma Tocotrienol Protects Mice From Targeted Thoracic Radiation Injury

C-reactive protein reduction post treatment is associated with improved survival in atezolizumab (anti-PD-L1) treated non-small cell lung cancer patients

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