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Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation.

Publication ,  Journal Article
Anscher, MS; Marks, LB; Shafman, TD; Clough, R; Huang, H; Tisch, A; Munley, M; Herndon, JE; Garst, J; Crawford, J; Jirtle, RL
Published in: J Clin Oncol
September 1, 2001

PURPOSE: The ability to prescribe treatment based on relative risks for normal tissue injury has important implications for oncologists. In non-small-cell lung cancer, increasing the dose of radiation may improve local control and survival. Changes in plasma transforming growth factor beta (TGFbeta) levels during radiotherapy (RT) may identify patients at low risk for complications in whom higher doses of radiation could be safely delivered. PATIENT AND METHODS: Patients with locally advanced or medically inoperable non-small-cell lung cancer received three-dimensional conformal RT to the primary tumor and radiographically involved nodes to a dose of 73.6 Gy (1.6 Gy twice daily). If the plasma TGFbeta level was normal after 73.6 Gy, additional twice daily RT was delivered to successively higher total doses. The maximum-tolerated dose was defined as the highest radiation dose at which < or = one grade 4 (life-threatening) late toxicity and < or = two grade 3 to 4 (severe life-threatening) late toxicities occurred. RESULTS: Thirty-eight patients were enrolled. Median follow-up was 16 months. Twenty-four patients were not eligible for radiation dose escalation beyond 73.6 Gy because of persistently abnormal TGFbeta levels. Fourteen patients whose TGFbeta levels were normal after 73.6 Gy were escalated to 80 Gy (n = 8) and 86.4 Gy (n = 6). In the 86.4-Gy group, dose-limiting toxicity was reached because there were two (33%) grade 3 late toxicities. CONCLUSION: It is feasible to use plasma TGFbeta levels to select patients for RT dose escalation for non-small-cell lung cancer. The maximum-tolerated dose using this approach is 86.4 Gy.

Duke Scholars

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

September 1, 2001

Volume

19

Issue

17

Start / End Page

3758 / 3765

Location

United States

Related Subject Headings

  • Transforming Growth Factor beta
  • Survival Rate
  • Sensitivity and Specificity
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Radiation Injuries
  • Prospective Studies
  • Patient Selection
  • Oncology & Carcinogenesis
  • Middle Aged
 

Citation

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Anscher, M. S., Marks, L. B., Shafman, T. D., Clough, R., Huang, H., Tisch, A., … Jirtle, R. L. (2001). Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. J Clin Oncol, 19(17), 3758–3765. https://doi.org/10.1200/JCO.2001.19.17.3758
Anscher, M. S., L. B. Marks, T. D. Shafman, R. Clough, H. Huang, A. Tisch, M. Munley, et al. “Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation.J Clin Oncol 19, no. 17 (September 1, 2001): 3758–65. https://doi.org/10.1200/JCO.2001.19.17.3758.
Anscher MS, Marks LB, Shafman TD, Clough R, Huang H, Tisch A, et al. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. J Clin Oncol. 2001 Sep 1;19(17):3758–65.
Anscher, M. S., et al. “Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation.J Clin Oncol, vol. 19, no. 17, Sept. 2001, pp. 3758–65. Pubmed, doi:10.1200/JCO.2001.19.17.3758.
Anscher MS, Marks LB, Shafman TD, Clough R, Huang H, Tisch A, Munley M, Herndon JE, Garst J, Crawford J, Jirtle RL. Using plasma transforming growth factor beta-1 during radiotherapy to select patients for dose escalation. J Clin Oncol. 2001 Sep 1;19(17):3758–3765.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

September 1, 2001

Volume

19

Issue

17

Start / End Page

3758 / 3765

Location

United States

Related Subject Headings

  • Transforming Growth Factor beta
  • Survival Rate
  • Sensitivity and Specificity
  • Radiotherapy, Conformal
  • Radiotherapy Dosage
  • Radiation Injuries
  • Prospective Studies
  • Patient Selection
  • Oncology & Carcinogenesis
  • Middle Aged