Published online Mar 21, 2017. doi: 10.3748/wjg.v23.i11.2077
Peer-review started: October 18, 2016
First decision: December 2, 2016
Revised: December 26, 2016
Accepted: January 17, 2017
Article in press: January 17, 2017
Published online: March 21, 2017
To analyze cytokine levels and to identify their association with outcome in patients with hepatocellular carcinoma (HCC) treated with radiotherapy (RT).
Patients with HCC who were treated with RT were eligible for this prospective study. Blood samples were collected before and after RT, and serum cytokine levels including interleukin (IL)-1, IL-6, IL-8, IL-10, IL-12, and tumor necrosis factor-α were analyzed.
Between 2008 and 2009, 51 patients were enrolled in this study. Baseline IL-6 level was high in patients with a history of pre-RT treatment. Median survival was 13.9 mo with alpha-fetoprotein (AFP) as a significant factor (P = 0.020). Median failure-free survival (FFS) for infield, outfield-intrahepatic and extrahepatic failures were 23.3, 11.5 and 12.0 mo, respectively. Sex and baseline IL-6 level were associated with infield FFS, and baseline IL-10 level was correlated with outfield-intrahepatic FFS. For extrahepatic FFS, AFP was significant (P = 0.034). Patients with a baseline IL-6 level of ≥ 9.7 pg/mL showed worse infield FFS (P = 0.005), and this significance was observed only in treatment-non-naïve patients (P = 0.022).
In addition to AFP, cytokines seem useful in predicting infield and outfield-intrahepatic failure. Serum cytokines could be useful biomarkers for predicting RT outcome in HCC.
Core tip: A prospective study to identify associations between serum cytokine levels and radiotherapy (RT) outcomes was performed in 51 patients with hepatocellular carcinoma. Baseline serum interleukin (IL)-6 levels were higher in patients with treatment failure than in those without treatment failure. This significant difference was observed only in treatment-non-naïve patients. To predict RT outcomes, analysis of baseline serum IL-6 levels may be helpful.