Abstract
BackgroundConformal radiotherapy is a primary treatment in head and neck cancer, which putative adverse effects depend on relatively low doses of radiation delivered to increased volumes of normal tissues. Systemic effects of such treatment include radiation-induced changes in serum lipid profile, yet dose- and volume-dependence of these changes remain to be established.MethodsHere we analyzed levels of choline-containing phospholipids in serum samples collected consecutively during the radiotherapy used as the only treatment modality. The liquid chromatography–mass spectrometry (LC-MS) approach applied in the study enabled the detection and quantitation of 151 phospholipids, including (lyso)phosphatidylcholines and sphingomyelins.ResultsNo statistically significant differences were found in the pretreatment samples from patients with different locations and stages of cancer. To compensate for potential differences between schemes of radiotherapy, the biologically effective doses were calculated and used in the search of correlations with specific lipid levels. We found that the levels of several phospholipids depended on the maximum dose delivered to the gross tumor volume and total radiation energy absorbed by the patient’s body. Increased doses correlated with increased levels of sphingomyelins and reduced levels of phosphatidylcholines. Furthermore, we observed several phospholipids whose serum levels correlated with the degree of acute radiation toxicity.ConclusionNoteworthy, serum phospholipid levels were associated mainly with volumes of normal tissues irradiated with relatively low doses (i.e., total accumulated dose 20 Gy), which indicated the importance of such effects on the systemic response of the patient’s organism to intensity-modulated radiotherapy (IMRT).
Highlights
Materials and methodsHead and neck squamous cell carcinoma (HNSCC) involves different squamous cell carcinomas located in the larynx, pharynx, oral cavity, and tongue, i.e., organs that play crucial roles in respiratory, nutritional, social, and communicative functions
RT is delivered using techniques of conformal radiation therapy, including intensity-modulated radiotherapy (IMRT), where a high dose better conforms to the tumor shape, enabling a reduction of the dose delivered to adjacent critical organs [3]
The analysis of serum lipidome was performed in a group of HNSCC patients treated with IMRT alone according to different treatment plans (Table 1)
Summary
Materials and methodsHead and neck squamous cell carcinoma (HNSCC) involves different squamous cell carcinomas located in the larynx, pharynx, oral cavity, and tongue, i.e., organs that play crucial roles in respiratory, nutritional, social, and communicative functions. A potential drawback of IMRT is an exposure of a large volume of normal tissues to low/medium doses This approach may still increase the risk of undesirable adverse effects in normal tissues, which may reduce the patients’ quality of life [4] and lead to unplanned therapy interruptions [5]. Conformal radiotherapy is a primary treatment in head and neck cancer, which putative adverse effects depend on relatively low doses of radiation delivered to increased volumes of normal tissues. Systemic effects of such treatment include radiation-induced changes in serum lipid profile, yet dose- and volume-dependence of these changes remain to be established
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