Serum proinflammatory cytokine response in patients with advanced liver tumors following selective internal radiation therapy (SIRT) with (90)yttriummicrospheres

Purpose: To determine the changes in serum levels of proinflammatory cytoki nes within 48 h after selective internal radiation treatment (SIRT) in pati ents with advanced liver cancers, Methods and Materials: Twenty-eight patients with advanced liver cancers wh o underwent SIRT were recruited into the study. Serum levels of interleukin (IL)-1 beta, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-alpha, and in terferon-gamma were determined prior to and 3, 6, 12, 24, and 48 h after SI RT, Their changes were correlated to adverse reactions following treatment as assessed by constitutional symptom scores, and routine blood and liver f unction tests at 24 and 48 h post-SIRT and falls in serum carcinoembryonic antigen (CEA) level 1 month post-SIRT, Results: Serum IL-6 levels were significantly increased at 24 (p less than or equal to 0.05) and 48 h (p less than or equal to 0.01) post-SIRT, In con trast, there was no significant change in the serum levels of other cytokin es studied. The increase in serum IL-6 at 24 h post-SIRT was significantly correlated with the changes in serum alanine transferase (p less than or eq ual to 0.05) and C-reactive protein (p less than or equal to 0.001) levels and total Leukocyte counts (p less than or equal to 0.001) at both 24 and 4 8 h post-SIRT, Changes in serum IL-6 level were also significantly correlat ed to the rise of serum aspartate transaminase levels at 48 h post-SIRT (p less than or equal to 0.001), but not with the scores of constitutional sym ptoms or the changes of serum CEA at 1 month post-SIRT, Conclusion: Absence of significant changes in most of proinflammatory cytok ines studied confirmed that SIRT is a reasonably safe and well-tolerated tr eatment with minimal side-effect from the point of view of cytokine-related inflammation, The correlation of serum IL-6 changes with several liver enz ymes and C-reactive protein but not with clinical symptom scores or serum C EA levels suggests that the rise in IL-6 levels in the first 48 h following SIRT most likely reflect normal liver cell damage rather than tumor cell d amage, (C) 2001 Elsevier Science Inc.