Plasma citrulline concentration: A surrogate end point for radiation-induced mucosal atrophy of the small bowel. A feasibility study in 23 patients

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• 作者：Ludy C. H. W. Lutgens ; Nicolaas Deutz ; Marlies Granzier-Peeters ; Regina Beets-Tan ; Dirk De Ruysscher ; John Gueulette ; Jack Cleutjens ; Martijn Berger ; BradlyWouters ; Maarten von Meyenfeldt ; Philippe Lambin
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2004
• 出版时间：1 September 2004
• 年：2004
• 卷：60
• 期：1
• 页码：275-285
• 全文大小：541 K

文摘

<h3 class=""h3"">Purposeh3>Plasma citrulline, a nitrogen end product of glutamine metabolism in small-bowel enterocytes, was suggested as a marker of radiation-induced small-bowel epithelial cell loss in mice after single-dose whole-body irradiation. Our objective was to evaluate the feasibility of citrulline as a marker for radiation-induced small-intestinal mucosal atrophy in patients during and after abdominal fractionated radiotherapy.<h3 class=""h3"">Methods and materialsh3>

Twenty-three patients were studied weekly during treatment and at intervals of 2 weeks and 3 and 6 months after treatment by postabsorptive plasma citrulline concentration and clinical toxicity grading. The interrelationship between these variables and the correlation with small-bowel dose and volume parameters were investigated.<h3 class=""h3"">Resultsh3>

During fractionated radiotherapy, citrulline concentration significantly decreased as a function of the radiation dose (p c; 0.001) and the volume of small bowel treated (p = 0.001). The plasma citrulline concentration correlated with clinical toxicity during the last 3 weeks of treatment. As a whole, citrulline concentration correlated better with radiation dose and volume parameters than clinical toxicity grading.<h3 class=""h3"">Conclusionsh3>

In patients treated with fractionated radiation therapy for abdominal or pelvic cancer sites, plasma citrulline concentration may be a simple objective marker for monitoring epithelial cell loss, a major event in acute radiation-induced small-bowel toxicity.