Serum transforming growth factor-β1 change after neoadjuvant chemoradiation therapy is associated with postoperative pulmonary complications in esophageal cancer patients undergoing combined modality therapy
Journal
International Journal of Radiation Oncology Biology Physics
Journal Volume
93
Journal Issue
5
Pages
1023-1031
Date Issued
2015
Author(s)
Wu J.-K.
Koong A.C.
Chang D.T.
Abstract
Purpose Our aim was to investigate the association of clinical factors, dosimetric parameters, and biomarkers with postoperative pulmonary complications (PPCs) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) treated by neoadjuvant concurrent chemoradiation therapy (CCRT) under strict pulmonary dose constraints and esophagectomy. Methods and Materials We prospectively enrolled 112 patients undergoing trimodality treatment (including radiation therapy [40 Gy], concurrent taxane-/5-fluorouracil-based regimens, and radical esophagectomy) for ESCC. A PPC was defined as pneumonia or acute respiratory distress syndrome within 30 days after surgery. Serum samples were collected before and within 1 month after CCRT. The association of serum biomarkers with PPCs was detected by proximity ligation assay (PLA) and verified by enzyme-linked immunosorbent assay. Associations of clinical factors, lung dosimetric parameters, and biomarkers with PPC were tested statistically. Results Thirty-three patients (29.5%) had PPCs. None of the dosimetric parameters was associated with PPCs. Preoperative functional vital capacity (FVC) was significantly associated with PPCs (P=.004). Of the 15 PLA-screened biomarkers, posttreatment transforming growth factor-β1 (TGF-β1) was borderline significantly associated with PPCs (P=.087). Patients with PPCs had significantly larger pre-CCRT to post-CCRT decrease in serum TGF-β1 concentration (-11,310 vs -5332 pg/mL, P=.005) and higher pre-CCRT to post-CCRT percent decline in serum TGF-β1 concentration (-37.4% vs -25.0%, P=.009) than patients without PPCs. On multivariate analysis, preoperative FVC (P=.003) and decrease in TGF-β1 >7040 pg/mL (P=.014) were independent factors associated with PPCs. Conclusions Preoperative FVC and decrease in serum TGF-β1 level after dose-limited CCRT to the lung are associated with the development of PPCs. ? 2015 Elsevier Inc.
SDGs
Other Subjects
Biological organs; Chemoradiotherapy; Dosimetry; Multivariant analysis; Radiotherapy; Acute respiratory distress syndrome; Combined modality therapy; Concurrent chemoradiation; Enzyme linked immunosorbent assay; Esophageal squamous cell carcinoma; Neoadjuvant chemoradiation; Pulmonary complications; Transforming growth factors; Biomarkers; antineoplastic agent; Axl protein; bone morphogenetic protein 2; bone morphogenetic protein 4; collagenase 3; epidermal growth factor receptor; epidermal growth factor receptor 2; FAM84B protein; fluorouracil derivative; growth arrest specific protein 6; interstitial collagenase; osteonectin; osteopontin; peptides and proteins; platelet derived growth factor alpha receptor; somatomedin binding protein 3; taxane derivative; transcription factor RUNX2; transforming growth factor beta1; tumor marker; unclassified drug; vasculotropin A; antineoplastic agent; bridged compound; fluorouracil; taxane; taxoid; transforming growth factor beta1; tumor marker; adjuvant chemoradiotherapy; adjuvant therapy; adult; adult respiratory distress syndrome; advanced cancer; aged; Article; assay; cancer chemotherapy; cancer patient; cancer radiotherapy; cancer surgery; chemical analysis; clinical feature; disease association; dosimetry; enzyme linked immunosorbent assay; esophageal squamous cell carcinoma; esophagus resection; female; forced vital capacity; human; intensity modulated radiation therapy; lung complication; major clinical study; male; multimodality cancer therapy; pneumonia; postoperative complication; preoperative evaluation; priority journal; prospective study; protein blood level; proximity ligation assay; radiotherapy planning system; adverse effects; blood; Carcinoma, Squamous Cell; chemoradiotherapy; Esophageal Neoplasms; middle aged; multivariate analysis; pathology; pneumonia; procedures; Respiratory Distress Syndrome, Adult; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Bridged Compounds; Carcinoma, Squamous Cell; Chemoradiotherapy; Enzyme-Linked Immunosorbent Assay; Esophageal Neoplasms; Esophagectomy; Female; Fluorouracil; Humans; Male; Middle Aged; Multivariate Analysis; Neoadjuvant Therapy; Pneumonia; Prospective Studies; Respiratory Distress Syndrome, Adult; Taxoids; Transforming Growth Factor beta1
Publisher
Elsevier Inc.
Type
journal article