Dynamic changes in T-cell subsets and C-reactive protein after radiation therapy in lung cancer patients and correlation with symptomatic radiation pneumonitis treated with steroid therapy
Authors Bai L, Zhou BS, Zhao YX
Received 19 March 2019
Accepted for publication 25 July 2019
Published 22 August 2019 Volume 2019:11 Pages 7925—7931
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Professor Bilikere Dwarakanath
Lu Bai,1 Bao-Sen Zhou,2,3 Yu-Xia Zhao4
1Department of Radiation Oncology, First Affiliated Hospital of China Medical University, Shenyang 110001, People’s Republic of China; 2Department of Epidemiology, School of Public Health, China Medical University, Shenyang 110122, People’s Republic of China; 3Liaoning Provincial Department of Education, Key Laboratory of Cancer Etiology and Prevention, First Affiliated Hospital of China Medical University, Shenyang 110001, People’s Republic of China; 4Department of Radiation Oncology, Fourth Affiliated Hospital of China Medical University, Shenyang 110032, People’s Republic of China
Correspondence: Yu-Xia Zhao
Department of Radiation Oncology, Fourth Affiliated Hospital of China Medical University, 4 Eastern Chongshan Road, Huanggu District, Shenyang Liaoning 110032, People’s Republic of China
Tel +86 246 204 3519
Objectives: To investigate relationships among serum T-cell subsets, CRP, levels and radiation pneumonitis (RP) in lung cancer patients receiving radiotherapy.
Methods: A case–control study with frequency matching was carried out. The case group comprised 36 lung cancer patients who had developed grade ≥2 RP after thoracic radiotherapy. The control group was 36 patients with lung cancer without RP. Patients in the case group received steroid therapy for 1 month after diagnosis of RP and were followed up for 3 months. T-cell subsets, CRP, and pulmonary function were detected at three time points (onset of RP and 1 and 3 months after diagnosis). Data for the control group were collected 3 months after radiotherapy. Treatment effectiveness was evaluated at 1 and 3 months after diagnosis of RP.
Results: Of the 36 patients in the case group, three with grade5 RP died from respiratory failure. The other 33 cases had all improved with steroid therapy at 3 months after RP diagnosis. In these 33, CD3+,T-cell quantity, CD4+,T-cell quantity, and of CD4+,:CD8+, ratio in T-cell subsets decreased significantly and CRP increased (P<0.05) at the onset of RP compared with the control group. After steroid therapy, CD4+,T-cell quantity increased significantly compared to before treatment. The same change was seen in CD4+,:CD8+, ratio, whereas CRP levels decreased obviously, with treatment effectiveness improved. In addition, with the damage level of RP increased, CD4+, T -cell quantity decreased obviously and CRP levels increased accordingly at the onset of RP (P<0.05).
Conclusion: T-cell subsets and CRP may become effective immunological biomarkers for predicting damage from RP and evaluating treatment effectivesness of steroid therapy.
Keywords: T-cell subsets, radiation pneumonitis, steroid therapy, radiotherapy, C-reactive protein
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