Study on the correlation of serum amyloid A level with overall survival and radiation pneumonitis in non‐small cell lung cancer patients receiving thoracic radiotherapy

Abstract

Objective: Serum amyloid A (SAA) is a non-specific acute phase reaction protein that shows much higher levels in patients with cancer than in healthy individuals. The present study was designed to investigate the correlation of SAA level with overall survival (OS) and radiation pneumonitis (RP) in non-small cell lung cancer patients receiving thoracic radiotherapy. Methods:Patients with locally advanced non-small cell lung cancer receiving thoracic radiotherapy or concurrent chemoradiotherapy were eligible for the study. Plasma samples were collected before radiotherapy (baseline), 2 and 4 weeks during radiotherapy, and at 3 months after the end of radiotherapy. The incidence of RP was recorded 1 year after radiotherapy. OS was defined as the interval between the date of treatment initiation and the date of death or last follow up if the patients were still alive. SPSS 18.0 and GraphPad Prism 5.0 software were used for statistical analyses, and P ≤ 0.05 was considered significant. Results:In total, data from 114 patients were used for the final analyses. The median baseline SAA level was 101.4 g/mL; patients with lower baseline SAA levels had a longer OS than those with a higher SAA level (25.8 vs 14.3 months, 2 = 5.519, P = 0.019). In multivariate analysis, sex, radiation dose, and baseline SAA level were independent prognostic factors. The SAA level after radiotherapy was significantly lower than that at baseline (142.6 vs 420.1 g/mL, t = 3.50, P = 0.001).The average SAA level in patients with grade 2 or higher and less than grade 2 RP after radiotherapy was 476.7 g/mL and 113.0 g/mL, respectively, t = 2.72, P = 0.009. Conclusions:SAA level might be a predictive biomarker for RP and OS in patients with locally advanced non-small cell lung cancer receiving thoracic radiotherapy.

Proteomic Profiling of Saliva and Tears in Radiated Head and Neck Cancer Patients as Compared to Primary Sjögren’s Syndrome Patients

“…Interestingly, we found that saliva in HNC patients demonstrated upregulated levels of serum amyloid A-1, while this protein was not found in tear fluid. The serum amyloid proteins have powerful pro-inflammatory and cytokine-like properties, and have been found to be highly expressed in a number of malignancies [ 24 , 25 ]. Thus, this protein could play a role in the acute and late effects of RT, and the upregulated levels in saliva as compared to tears may be a consequence of the lower radiation dose received by the lacrimal glands.…”