Serum proinflammatory cytokine response in patients with advanced liver tumors following selective internal radiation therapy (SIRT) with (90)Yttrium microspheres.

Abstract

PURPOSE:

To determine the changes in serum levels of proinflammatory cytokines within 48 h after selective internal radiation treatment (SIRT) in patients with advanced liver cancers.

METHODS AND MATERIALS:

Twenty-eight patients with advanced liver cancers who underwent SIRT were recruited into the study. Serum levels of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha, and interferon-gamma were determined prior to and 3, 6, 12, 24, and 48 h after SIRT. Their changes were correlated to adverse reactions following treatment as assessed by constitutional symptom scores, and routine blood and liver function tests at 24 and 48 h post-SIRT and falls in serum carcinoembryonic antigen (CEA) level 1 month post-SIRT.

RESULTS:

Serum IL-6 levels were significantly increased at 24 (p < or = 0.05) and 48 h (p < or = 0.01) post-SIRT. In contrast, there was no significant change in the serum levels of other cytokines studied. The increase in serum IL-6 at 24 h post-SIRT was significantly correlated with the changes in serum alanine transferase (p < or = 0.05) and C-reactive protein (p < or = 0.001) levels and total leukocyte counts (p < or = 0.001) at both 24 and 48 h post-SIRT. Changes in serum IL-6 level were also significantly correlated to the rise of serum aspartate transaminase levels at 48 h post-SIRT (p < or = 0.001), but not with the scores of constitutional symptoms or the changes of serum CEA at 1 month post-SIRT.

CONCLUSION:

Absence of significant changes in most of proinflammatory cytokines studied confirmed that SIRT is a reasonably safe and well-tolerated treatment with minimal side-effect from the point of view of cytokine-related inflammation. The correlation of serum IL-6 changes with several liver enzymes and C-reactive protein but not with clinical symptom scores or serum CEA levels suggests that the rise in IL-6 levels in the first 48 h following SIRT most likely reflect normal liver cell damage rather than tumor cell damage.

• Authors: J K Wickremesekera, W Chen, R J Cannan, R S Stubbs
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 49 Issue 4 Pg. 1015-21 (Mar 15 2001) ISSN: 0360-3016 [Print] United States
• PMID: 11240242 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Carcinoembryonic Antigen
• Interleukin-6
• Interleukins
• Neoplasm Proteins
• Tumor Necrosis Factor-alpha
• Yttrium Radioisotopes
• Interferon-gamma
• C-Reactive Protein
• Aspartate Aminotransferases
• Alanine Transaminase

Topics

• Adult
• Aged
• Alanine Transaminase (blood)
• Aspartate Aminotransferases (blood)
• Brachytherapy (adverse effects, methods)
• C-Reactive Protein (metabolism)
• Carcinoembryonic Antigen (blood)
• Female
• Humans
• Interferon-gamma (blood)
• Interleukin-6 (blood)
• Interleukins (blood)
• Leukocyte Count
• Liver Neoplasms (blood, radiotherapy)
• Male
• Microspheres
• Middle Aged
• Neoplasm Proteins (blood)
• Time Factors
• Tumor Necrosis Factor-alpha (metabolism)
• Yttrium Radioisotopes (therapeutic use)