Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2017; 23(11): 2077-2085
Published online Mar 21, 2017. doi: 10.3748/wjg.v23.i11.2077
Multi-analyte analysis of cytokines that predict outcomes in patients with hepatocellular carcinoma treated with radiotherapy
Hyejung Cha, Eun Jung Lee, Jinsil Seong
Hyejung Cha, Eun Jung Lee, Jinsil Seong, Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, South Korea
Hyejung Cha, Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, South Korea
Author contributions: Seong J designed the study; Cha H and Lee EJ analyzed the data; Cha H wrote the paper.
Supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (No. A121982) and by a grant from the Mid-Career Researcher Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, Future Planning (No. NRF-2014R1A2A1A11054463).
Institutional review board statement: This study was reviewed and approved by the Yonsei Severance Hospital Institutional Review Board (IRB number: 4-2008-2012).
Informed consent statement: All patients of this study were enrolled after providing written informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest relevant to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jinsil Seong, MD, PhD, Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 06351, South Korea. jsseong@yuhs.ac
Telephone: +82-2-22288111 Fax: +82-2-22277823
Received: October 12, 2016
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
Abstract
AIM

To analyze cytokine levels and to identify their association with outcome in patients with hepatocellular carcinoma (HCC) treated with radiotherapy (RT).

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Keywords: Hepatocellular carcinoma, Radiotherapy, Cytokine, Interleukin-6

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.