Lung function and serum concentration of tumor necrosis factor-alpha, interleukin-6 and fibronectin in patients treated with ABVD chemotherapy followed by radiotherapy for mediastinal Hodgkin's disease

Mediastinal radiotherapy and polychemotherapy regimens can produce late tox icity leading to pulmonary fibrosis. There is evidence for the involvement of various cytokines in this process. We evaluated lung fraction in 20 pati ents with stage I-ILA Hodgkin's disease and submitted to chemotherapy inclu ding bleomycin (ABVD) and radiotherapy. Lung function tests were performed before, at the end of treatment and after a median of 12 months from the en d of therapy. Tumor necrosis factor-alpha (TNF-alpha), fibronectin and inte rleukin-6 (IL-6) were determined on serum samples collected at the same tim e intervals. A modification of tests indicative of a restrictive lung disea se was observed at end of treatment, whereas a persistent decline of transf er lung factor for carbon monoxide (DLCO) was documented. TNF-alpha constan tly decreased, fibronectin increased and IL-6 showed a decline after treatm ent and a rise during the follow-up brit the differences were not statistic ally significant. No significant correlations were observed between changes of lung function tests and serum cytokine concentration. Conclusions. This lack of correlation could be due to: a) incorrect selecti on of serum collection rime, or b) to the fact that cytokine plasma concent ration does not reflect events occurring in the alveolar phase.