Transforming growth factor-beta-1 is a serum biomarker of radiation-induced pneumonitis in esophageal cancer patients treated with thoracic radiotherapy: preliminary results of a prospective study

Figures & data

Table 1 Patients’ characteristics

Characteristics	Patients		Group		P-value
	n	%	RP	NRP
	63	100	17	46
Age(years)					0.461
≤60	27	42.9	6	21
>60	36	57.1	11	25
Sex					0.279
Male	30	47.6	10	20
Female	33	52.4	7	26
Smoking					0.713
Yes	26	41.3	12	14
No	37	58.7	5	32
Chemotherapy					0.656
Yes	47	74.6	12	35
No	16	25.4	5	11
Radiation dose					0.042
≤60 Gy	24	38.1	3	21
>60 Gy	39	61.9	14	25
Tumer location					0.595
Upper*	14	22.2	3	11
Mid/Low*	49	77.8	14	35

Notes:

* Tumor location was defined by Union for International Cancer Control.

Abbreviations: n, number; RP, radiation-induced pneumonitis; NRP, non-radiation-induced pneumonitis.

Figure 1 Changes in TGF-β1 between the RP group and NRP group.

Notes: This image indicates that the cytokine level was 37.77±9.67 pg/mL in RP and 42.13±10.49 pg/mL in NRP before RT. With increasing RT times, the difference between the two groups is readily discernible at the radiation dose of 40 Gy (P=0.00). At the same time, the levels of TGF-β1 were significantly higher than before radiotherapy in the RP group. However, in the NRP group, when compared with before RT, changes in TGF-β1 levels were not statistically significant at each time point of RT (P=0.131; 0.187; 0.317; 0.092). ***Pμ0.01.
Abbreviations: TGF-β1, transforming growth factor-beta-1; RT, radiotherapy; RP, radiation-induced pneumonitis; NRP, non-radiation-induced pneumonitis.

Table 2 Results of repeated measures ANOVA regarding changes in the mean TGF-β1 levels during the course of RT

Mean ± SD (pg/mL)V
	Before RT	Dose of 40 Gy	1 day after RT	1 month after RT	3 months after RT	Repeated source	F	ANOVA P-value
RP (n=17)	37.77±9.67	55.75±10.85	97.22±14.66	160.20±28.45	272.89±36.71	Time	523.95	0.000
NRP (n=46)	42.13±10.49	45.30±9.44	45.26±12.06	44.37±10.87	46.06±11.64	Time*RP	510.42	0.000

Abbreviations: ANOVA, analysis of variance; TGF-β1, transforming growth factor-beta-1; RT, radiotherapy; SD, standard deviation; RP, radiation-induced pneumonitis; n, number; NRP, non-radiation-induced pneumonitis.

Figure 2 Changes in IL-1β between the RP group and NRP group.

Abbreviations: IL-1β, interleukin-1 beta; RT, radiotherapy; RP, radiation-induced pneumonitis; NRP, non-radiation-induced pneumonitis.

Table 3 Results of repeated measures ANOVA regarding changes in the mean IL-1β levels during the course of RT

Mean ± SD (pg/mL)
	Before RT	Dose of 40 Gy	1 day after RT	1 month after RT	3 months after RT	Repeated source	F	ANOVA P-value
RP (n=17)	1.24±0.22	1.32±0.42	1.38±0.25	1.40±0.32	1.43±0.38	Time	4.174	0.005
NRP (n=46)	1.18±0.21	1.14±0.44	1.26±0.31	1.27±0.34	1.29±0.33	Time*RP	0.271	0.896

Abbreviations: ANOVA, analysis of variance; IL-1β, interleukin-1 beta; RT, radiotherapy; SD, standard deviation; RP, radiation-induced pneumonitis; n, number; NRP, non-radiation-induced pneumonitis.

Figure 3 Changes in ACE between the RP group and NRP group.

Notes: The ACE levels lowered significantly in the RP group before RT (P=0.00). With the passage of time and RT, the levels of ACE tended to decrease in the RP and NRP groups, but when compared with before RT, the changes in ACE levels were not statistically significant at each time point of RT. ***Pμ0.01.
Abbreviations: ACE, angiotensin-converting enzyme; RT, radiotherapy; RP, radiation-induced pneumonitis; NRP, non-radiation-induced pneumonitis.

Table 4 Results of repeated measures ANOVA regarding the changes in the mean ACE levels during the course of RT

Mean ± SD (pg/mL)
	Before RT	Dose of 40 Gy	1 day after RT	1 month after RT	3 months after RT	Repeated source	F	ANOVA P-value
RP (n=17)	9.13±1.12	9.08±1.60	9.04±1.43	8.86±1.24	8.48±1.42	Time	0.945	0.445
NRP (n=46)	12.79±2.17	12.51±2.57	12.20±2.64	11.93±2.34	11.96±2.82	Time*RP	0.181	0.947

Abbreviations: ANOVA, analysis of variance; ACE, angiotensin-converting enzyme; RT, radiotherapy; SD, standard deviation; RP, radiation-induced pneumonitis; n, number; NRP, non-radiation-induced pneumonitis.