Prediction of radiation pneumonitis in lung cancer patients: a systematic review

Zhang, Xiaojing; Sun, Jianping; Sun, Jie; Hua, Ming; Wang, Xinxin; Wu, Lei; Chen, Zhengtang

doi:10.1007/s00432-012-1284-1

Cited by 124 publications

(124 citation statements)

References 69 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…27 Numerous studies have attempted to clarify the role of TGF-b in EMT 28 and the pathways involved in radiation-induced EMT. 18 Therefore, we studied the TGF-b signaling in response to radiation and identified that if TBK1 modulated it.…”

Section: Tgf-b/smad Pathway Are Not Attenuated By Tbk1 Inhibitionmentioning

confidence: 99%

Inhibition of TBK1 attenuates radiation-induced epithelial–mesenchymal transition of A549 human lung cancer cells via activation of GSK-3β and repression of ZEB1

Huang

et al. 2014

Laboratory Investigation

View full text Add to dashboard Cite

Radiotherapy is an effective treatment method for lung cancer, particularly when the disease is at an advanced stage. However, previous researchers have observed that the majority of patients with conventional radiation therapy develop distant metastases and succumb to the disease. Thus, identifying and understanding novel pathways for the development of new therapeutic targets is a major goal in research on pulmonary neoplasms. Recent studies suggest that epithelial-mesenchymal transition (EMT) is the most important contributor to cancer metastasis. Induction of this complex process requires endogenously produced microRNAs; specifically, downregulation of the miRNA-200c causes an induction of EMT. We recently identified the tank-binding kinase-1 (TBK1) as a downstream effector of the miR-200c-driven pathway, but the biological function of TBK1 in EMT remains unknown. In this study, we tested whether TBK1 has a role in radiation-induced EMT and identified associated potential mechanisms. Human alveolar type II epithelial carcinoma A549 cells were irradiated with 60 Co g-rays. Western blotting revealed a time-and dose-dependent decrease in E-cadherin with a concomitant increase in vimentin after radiation, suggesting that the epithelial cells acquired a mesenchymal-like morphology. TBK1 siRNA significantly inhibited radiationinduced suppression of the epithelial marker E-cadherin and upregulation of the mesenchymal marker vimentin. The invasion and migratory potential of lung cancer cells upon radiation treatment was also reduced by TBK1 knockdown. Furthermore, radiation-induced EMT attenuated by TBK1 depletion was partially dependent on transcriptional factor ZEB1 expression. Finally, we found glycogen synthase kinase-3b (GSK-3b) is involved in regulation of radiation-induced EMT by TBK1. Thus, our findings reveal that TBK1 signaling regulates radiation-induced EMT by controlling GSK-3b phosphorylation and ZEB1 expression. TBK1 may therefore constitute a useful target for treatment of radiotherapy-induced metastasis diseases.

show abstract

Section: Tgf-b/smad Pathway Are Not Attenuated By Tbk1 Inhibitionmentioning

confidence: 99%

Inhibition of TBK1 attenuates radiation-induced epithelial–mesenchymal transition of A549 human lung cancer cells via activation of GSK-3β and repression of ZEB1

Huang

et al. 2014

Laboratory Investigation

View full text Add to dashboard Cite

show abstract

“…Albeit developments in radiotherapy techniques, such as the Three-Dimensional Conformal Radiation Therapy (3DCRT) and the IntensityModulated Radiation Therapy (IMRT), which offer greater protection to adjacent healthy tissues and, at the same time, increase the dose absorbed by the tumour target, the frequency of RP has not been eliminated (Bucci et al, 2005;Tsoutsou and Koukourakis, 2006;Guckenberger et al, 2010). Although, some inflammatory mediators such as amifostine (Kouvaris et al, 2007) or Toll-like receptor agonism (Wang et al, 2012) have shown evidence of radioprotection in vitro and in vivo studies, RP clearly remains a radiation dosimetric-related morbidity (Zhang et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

Kouloulias

Zygogianni²,

Efstathopoulos³

et al. 2013

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

show abstract

“…Instead, the discriminatory power of the STRIPE score was validated to distinguish between intermediate risk and low risk of developing RP. A number of additional factors were included in the present analyses compared with the original analysis of STRIPE score (12); however, data was not gathered on other potential predictors of RP, such as baseline pulmonary function, the presence of lung fibrosis on baseline CT, low partial pressure of O 2 prior to radiotherapy and various biological factors, including transforming growth factor-B 1 levels (19,20).…”

Section: Discussionmentioning

confidence: 99%

Validation and optimization of a predictive model for radiation pneumonitis in patients with lung cancer

et al. 2016

View full text Add to dashboard Cite

Abstract. The aim of the current retrospective study was to validate a predictive model for radiation pneumonitis (STRIPE) in an independent dataset and to investigate whether the addition of other potential risk factors could strengthen the accuracy of the model. Consecutive patients with non-small cell lung carcinoma (NSCLC; n=71) treated with definitive concurrent chemotherapy and radiotherapy were retrospectively assessed for radiation pneumonitis (RP). The results identified that 16 (23%) patients developed grade ≥2 RP. Furthermore, STRIPE score (intermediate vs. low risk) was independently associated with the development of RP [odds ratio (OR), 3.72; 95% confidence interval (CI), 1.00-13.89], whereas current smoking status was found to be protective against RP (OR, 0.09; 95% CI, 0.01-0.78). Similar discriminatory power of the STRIPE score was observed as in the original study. The addition of smoking status strengthened the model's discriminatory ability to predict RP. Thus, the addition of smoking status as a risk factor may strengthen the accuracy of the model for predicting RP in patients with NSCLC.

show abstract

Prediction of radiation pneumonitis in lung cancer patients: a systematic review

Abstract: More attention should be paid to the levels of patients' pulmonary function, plasma TGF-β1 and dose-volume histogram (DVH). Rigorous studies are needed to identify the relationship between the above-mentioned factors and RP ≥grade 1 or 3.

Cited by 124 publications

References 69 publications

Inhibition of TBK1 attenuates radiation-induced epithelial–mesenchymal transition of A549 human lung cancer cells via activation of GSK-3β and repression of ZEB1

Inhibition of TBK1 attenuates radiation-induced epithelial–mesenchymal transition of A549 human lung cancer cells via activation of GSK-3β and repression of ZEB1

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

Validation and optimization of a predictive model for radiation pneumonitis in patients with lung cancer

Contact Info

Product

Resources

About