ABSTRACT
Objective To investigate the relationship between the plasma IL-6,ACE level and DVH parameters radiation pneumonitis,and to evaluate its clinical value on the prediction of radiation pneumonitis.Methods 60 patients with locally advanced non-small cell lung cancer patients with unresectable or unwilling to surgical resection routinely received three-dimensional conformal radiation therapy.Before radiotherapy,radiotherapy beginning 1 week,2 weeks,3 weeks,4 weeks,5 weeks,6 weeks,8 weeks and 12 weeks,enzyme-linked immunosorbent assay (ELISA) was used to detect IL-6 and ACE content.The evaluation of radiation pneumonitis was accordance with the RTOG acute radiation pneumonitis grading standards.The patients with radiation pneumonitis were included in observation group,otherwise as control group.IL-6,ACE and DVH parameters in two groups were analyzed.The DVH parameters includes V20,V20,MLD and NTP.Results Among all the 60 patients,16 cases were diagnosed as radiation pneumonitis,among whom 5 cases occurred in radiotherapy,10 cases occurred within one month after radiotherapy,1 case occurred in two months after radiotherapy,including the 11 cases of grade Ⅱ and the other 5 cases of grade Ⅲ.In the observation group and the control group,expression level of the IL-6 had statistical significance before and after radiotherapy,ACE had significant difference in 2rd,3rd,4th,5th,6th week after radiotherapy (all P ＜ 0.05).V20,V30 and MLD differences were statistically significant between the observation group and control group [(46.2±4.5) ％ vs (30.5±7.5) ％,(37.5±5.6) ％ vs (20.5±5.6) ％,(20.4±2.3) Gy vs (15.5±3.5) Gy,(25.2±8.2) ％ vs (9.9±4.5) ％,all P ＜ 0.05].Conclusion Plasma IL-6,ACE levels,V20,V30,the MLD,and NTP are related to the occurrence of radiation pneumonitis.