Elevated serum granulocyte-macrophage colony-stimulating factor levels during radiotherapy predict favorable outcomes in lung and esophageal cancer
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Guodong Deng1,*, Pingping Hu1,*, Jingxin Zhang2, Qiqi Liu1, Ning Liang1, Jian Xie1, Lili Qiao3, Hui Luo4, Deguo Xu1, Fengjun Liu1, Xinshuang Yu1, Zhen liu1, Yajuan Lv1, Jiandong Zhang1
1Department of Radiation Oncology, Qianfoshan Hospital, Shandong University, Jinan 250014, PR China
2Division of Oncology, Department of Graduate, Weifang Medical College, Weifang 261053, PR China
3Department of Oncology, The Fifth Peoples’ Hospital of Jinan, Jinan 250022, PR China
4Department of Radiation Oncology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou 450001, Henan, China
*These authors have contributed equally to this work
Jiandong Zhang, email: [email protected]
Keywords: granulocyte-macrophage colony-stimulating factor, interferon-γ, radiotherapy, cancer prognosis
Received: May 23, 2016 Accepted: October 26, 2016 Published: November 08, 2016
The combination of exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) with radiotherapy (RT) has been demonstrated to strengthen the antitumor immune response. We hypothesized that the variation of GM-CSF during RT was correlated with cancer prognosis. We measured serum levels of GM-CSF and interferon-γ (IFN-γ) before and during RT in 126 unresectable lung and esophageal cancer patients and performed survival analyses. Upregulated GM-CSF levels during RT correlated with longer overall survival (OS) and progression-free survival (PFS). On the other hand, no difference in OS or PFS was seen at different IFN-γ levels. However, the “integrated factor”, computed as the combination of high pre-RT IFN-γ levels and upregulated GM-CSF, correlated with prolonged OS and PFS. Multivariate analyses revealed that GM-CSF levels and the integrated factor were both stronger independent prognostic factors than disease stage. These data demonstrate that GM-CSF levels during RT can be used as a prognostic biomarker for lung and esophageal cancer.
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