Association of Circulating Inflammatory Biomarker Levels and Toxicity in Patients Undergoing Pelvic Radiation for Cancer: A Critical Review

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2025-03-24 DOI:10.1016/j.adro.2025.101766

Per Fessé PhD , Per-Arne Svensson PhD , Björn Zackrisson PhD , Alexander Valdman PhD , Per Fransson PhD , Kjell Grankvist PhD , Ingrid Kristensen PhD , Ulrica Langegård PhD , Emma Ohlsson-Nevo PhD , Katarina Sjövall PhD , Linda Åkeflo PhD , Karin Ahlberg PhD

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引用次数: 0

Abstract

Purpose

Radiation therapy (RT) causes tissue damage and inflammation. Because cytokines play a key role in such processes, their expression levels can be an indicator of cell and tissue toxicity. This critical review aims to explore whether levels of circulating inflammatory biomarkers in peripheral blood are associated with proton- or photon-based therapy in the pelvic area and how these levels vary over time. Further, we investigated whether these levels can be linked to radiation dose, the incidence of toxicity, and changes in toxicity over time.

Methods and Materials

A literature search was conducted in PubMed to find studies involving comparative cohorts of pelvic irradiated patients with cancer. Studies reporting on the association of markers in peripheral blood with inflammatory processes and/or toxicity were included.

Results

We found evidence of associations between changes in inflammatory cytokine levels and the total cumulative dose-volume together with RT-induced toxicity in patients with cancer treated with pelvic RT. Common patient-reported outcomes demonstrate an association between radiation toxicity (eg, genitourinary toxicity) and circulating inflammatory biomarker levels.

Conclusions

This review highlights that the total cumulative dose and irradiated tissue volume are the primary drivers of RT-induced biomarker expression, influencing both early and late toxicity outcomes. The diversity in RT techniques, total dose, and number of treatment sessions across studies likely contributes to the variation in observed results. Circulating cytokine and biomarker levels in the blood can provide valuable monitoring and predictive insights for patients undergoing proton- or photon-based RT of the pelvis. Biomarker analysis in the context of RT offers clinical value by enabling personalized treatment by helping predict which patients are at higher risk for certain toxicities, guiding clinicians in tailoring treatment, optimizing supportive care, and adjusting RT plans. This approach could improve patient outcomes and quality of life by reducing long-term complications from radiation exposure.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.