In Response to Drs. Anscher and Kong

Abstract

Anscher et al. ( 1 Anscher M.S. Kong F.M. et al. Significance of plasma transforming growth factor-beta levels in radiotherapy for non-small-cell lung cancer [Letter]. Int J Radiat Oncol Biol Phys. 2005; 61: 1276-1277 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar ) expressed some concerns regarding the methodology we used to determine plasma levels of transforming growth factor (TGF)-β1. His group at Duke University has repeatedly reported ( 2 Anscher M.S. Kong F.M. Marks L.B. et al. Changes in plasma transforming growth factor beta during radiotherapy and the risk of symptomatic radiation-induced pneumonitis. Int J Radiat Oncol Biol Phys. 1997; 37: 253-258 Abstract Full Text PDF PubMed Scopus (132) Google Scholar , 3 Anscher M.S. Kong F.M. Andrews K. et al. Plasma transforming growth factor beta1 as a predictor of radiation pneumonitis. Int J Radiat Oncol Biol Phys. 1998; 41: 1029-1035 Abstract Full Text Full Text PDF PubMed Scopus (228) Google Scholar , 4 Anscher M.S. Marks L.B. Shafman T.D. et al. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. J Clin Oncol. 2001; 19: 3758-3765 PubMed Google Scholar ) that in patients irradiated for lung cancer, elevations in TGF-β1 during radiotherapy were predictive for later development of radiation pneumonitis. The results of our study ( 5 De Jaeger K. Seppenwoolde Y. Kampinga H.H. et al. Significance of plasma transforming growth factor-beta levels in radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2004; 58: 1378-1387 Abstract Full Text Full Text PDF PubMed Scopus (82) Google Scholar ) could not confirm that increased levels of TGF-β1 are an independent risk factor for developing symptomatic radiation pneumonitis. TGF-β1 levels were shown to significantly correlate with a radiation dose-volume parameter for lung (i.e., the mean lung dose that is a strong predictor for radiation pneumonitis ( 6 Kwa S.L. Lebesque J.V. Theuws J.C. et al. Radiation pneumonitis as a function of mean lung dose An analysis of pooled data of 540 patients. Int J Radiat Oncol Biol Phys. 1998; 42: 1-9 Abstract Full Text Full Text PDF PubMed Scopus (645) Google Scholar )). In regard to De Jaeger et al.: Significance of plasma transforming growth factor-beta levels in radiotherapy for non–small-cell lung cancer (INT J RADIAT ONCOL BIOL PHYS 2004;58:1378–1387)International Journal of Radiation Oncology, Biology, PhysicsVol. 61Issue 4PreviewWe read with great interest the article by De Jaeger et al. (1). The authors report that plasma transforming growth factor β1 (TGFβ1) concentration at the end of radiation is associated with mean lung dose, one of the strongest dosimetric predictors for radiation pneumonitis. Meanwhile, they concluded that increased levels of TGFβ1 at the end of radiation were not predictive of the risk of radiation pneumonitis. We have some concerns pertaining to methodology and data analysis, which we would like to present to the authors for their comment. Full-Text PDF