Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

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

Fessé, Per ; Svensson, Per Arne ; Zackrisson, Björn ; Valdman, Alexander ; Fransson, Per ; Grankvist, Kjell ; Kristensen, Ingrid LU ; Langegård, Ulrica ; Ohlsson-Nevo, Emma and Sjövall, Katarina , et al. (2025) In Advances in Radiation Oncology 10(6).
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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Advances in Radiation Oncology
volume
10
issue
6
article number
101766
publisher
Elsevier
external identifiers
  • pmid:40620349
  • scopus:105002893120
ISSN
2452-1094
DOI
10.1016/j.adro.2025.101766
language
English
LU publication?
yes
id
fe361f33-10e5-430e-ba81-b56069730ebc
date added to LUP
2025-08-07 12:23:19
date last changed
2025-08-08 03:00:02
@article{fe361f33-10e5-430e-ba81-b56069730ebc,
  abstract     = {{<p>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.</p>}},
  author       = {{Fessé, Per and Svensson, Per Arne and Zackrisson, Björn and Valdman, Alexander and Fransson, Per and Grankvist, Kjell and Kristensen, Ingrid and Langegård, Ulrica and Ohlsson-Nevo, Emma and Sjövall, Katarina and Åkeflo, Linda and Ahlberg, Karin}},
  issn         = {{2452-1094}},
  language     = {{eng}},
  number       = {{6}},
  publisher    = {{Elsevier}},
  series       = {{Advances in Radiation Oncology}},
  title        = {{Association of Circulating Inflammatory Biomarker Levels and Toxicity in Patients Undergoing Pelvic Radiation for Cancer : A Critical Review}},
  url          = {{http://dx.doi.org/10.1016/j.adro.2025.101766}},
  doi          = {{10.1016/j.adro.2025.101766}},
  volume       = {{10}},
  year         = {{2025}},
}