Effects of chemoradiotherapy on acute-phase protein levels in glioblastoma multiforme and locally advanced non-small cell lung cancer

Çiğdem Damla Deniz,Mehmet Gürbilek,Mehmet Koç

doi:10.1515/tjb-2017-0215

Çiğdem Damla Deniz, Mehmet Gürbilek + Show 1 more

Open Access

https://doi.org/10.1515/tjb-2017-0215

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Abstract

Abstract Objective Chemoradiotherapy (CRT) is a commonly used therapeutic modality. We investigated CRT effects on acute phase reactants (APRs). The aim of this study was to assess possible changes in APR levels during radiotherapy and to determine the usefulness of APRs as prognostic factors in patients with non-small cell lung cancer (NSCLC) and glioblastoma multiforme (GBM). Methods We prospectively evaluated 30 patients and 30 healthy controls. Plasma levels of APRs were measured. Post-CRT and pre-CRT levels were compared. Survival of patients were also followed up for a period of 3 years. Results In NSCLC patients, post-CRT albumin, transferrin (Trf), and ceruloplasmin (Cp) levels were significantly lower, and post-CRT ferritin (FER) levels were significantly higher, than their pre-CRT levels. In GBM patients, post-CRT Trf and prealbumin (Prealb) levels were significantly higher than pre-CRT levels. Pre-CRT C-reactive protein (CRP) and FER levels in NSCLC patients and Cp levels in GBM patients were associated with patient survival. Conclusion This study suggests that APRs may be useful for monitoring response to treatment during CRT in NSCLC and GBM patients. Bearing in mind their accessibility and clinical value, plasma CRP and FER in NSCLC patients and Cp in GBM patients can be considered candidate prognostic factors.

Highlights

Lung cancer is the most common cause of cancer-related deaths
To investigate prognostic utility of C-reaktif protein (CRP), Trf, Cp, FER, Alb and Prealb during CRT in cancer patients, the present study evaluated plasma levels of acute phase reactant (APR) before and after completion of CRT by patients suffering from locally advanced Non-small cell lung cancer (NSCLC) and Glioblastoma multiforme (GBM)
There was no significant difference between Prealb levels before and after CRT in NSCLC group (5.26 ± 4.21 and 6.86 ± 6.22 mg/dL, respectively; p > 0.05), there was a significant difference in GBM group (10.8 ± 9.24; 19.4 ± 9.09 mg/dL;, respectively, p < 0.001) (Table 1)

Summary

Introduction

Lung cancer is the most common cause of cancer-related deaths. Non-small cell lung cancer (NSCLC) is responsible for more than 85% of lung cancer cases [1]. Standard treatment for patients with good performance status and inoperable stage III NSCLC is combined chemoradiotherapy (CRT) [2, 3]. Glioblastoma multiforme (GBM) is one of the most malignant neoplasms in humans [4]. Apart from other mechanisms, inflammatory cell-driven micro-environment, composed of a variety of cytokines, chemokines and enzymes, may lead to tumor initiation and promotion [5]. Despite standard treatment of surgery combined with radiotherapy (RT) and temozolomide, survival of GBM patients varies significantly, even among those who received the same treatment [6]

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