Skip to main content Accessibility help

Radiation-induced toxicity in cancer patients with low plasma fibronectin levels

  • Roxana G. Baluna (a1), Clifton D. Fuller (a2), Tony Y. Eng (a2), Federico L. Ampil (a1) and Charles R. Thomas (a3)...


The present study was carried out to evaluate the levels of plasma fibronectin (Fn) in cancer patients undergoing radiation therapy (RT) in correlation with outcomes in terms of radiation toxicity. A total of 26 patients with lung and gastrointestinal (GI) cancer, treated with RT were enrolled in this study. Plasma Fn levels were determined before and following a course of RT. The Radiation Therapy Oncology Group (RTOG) criteria were used to determine the grade of RT toxicity. Statistical analysis utilised the nonparametric Mann–Whitney U-test as well as bivariate linear regression. Pre-RT Fn levels were significantly higher in cancer patients without toxicity (median ± SE) (485.0 ± 87 μg/ml) as compared with the levels of plasma Fn in patients with grade I–II RTOG acute toxicity (354.0 ± 74 μg/ml, p = 0.01). No significant difference in Fn levels was found in patients with grade I toxicity compared with patients with grade II toxicity. In addition, low baseline Fn levels (148 and 299 μg/ml) were observed in two lung cancer patients who developed symptomatic pneumonitis during the first 2 months after RT. These preliminary results suggest that low baseline Fn may have potential as a predictive marker for development of RT-induced toxicity.


Corresponding author

Correspondence to: Roxana G. Baluna, Department of Radiology, Louisiana State University Health Science Center, 1501 Kings Highway, Shreveport, LA 71130, USA. Email:


Hide All
Stone, HB, McBride, WH, Colema, CN. Modifying normal tissue damage post-irradiation. Report of Workshop sponsored by the Radiation Research Program, National Cancer Institute, Bethesda, Maryland. Rad Res 2000; 157: 204223.
Anscher, MS, Chen, L, Rabbani, Z et al. Recent progress in defining mechanisms and potential targets for prevention of normal tissue injury after radiation therapy. Int J Radiat Oncol Biol Phys 2005; 62: 255259.
De Jaeger, K, Seppenwoolde, Y, Kampinga, H, Boersma, LJ, Belderbos, JS, Lebesque, JV. Significance of plasma transforming growth factor-β levels in radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2004; 58: 13781387.
Anscher, MS, Kong, FM, Andrews, K et al. Plasma transforming growth factor beta1 as a predictor of radiation pneumonitis 1998. Int J Radiat Oncol Biol Phys 1998; 41: 10291035.
Chen, J, Williams, J, Ding, I et al. Radiation pneumonitis and early circulatory cytokine markers. Semin Radiat Oncol 2002; 12: 2633.
Ishii, Y, Kitamura, S. Soluble intercellular adhesion molecule-1 as an early detection marker for radiation pneumonitis. Eur Respir J 1999; 13: 733738.
Chen, Y, Hyrien, O, Williams, J, Okunieff, P, Smudzin, T, Rubin, P. Interleukin (IL)-1A and IL-6: applications to the predictive diagnostic testing of radiation pneumonitis. Int J Radiat Oncol Biol Phys 2005; 62: 260266.
Baluna, RG, Eng, TY, Thomas, CR. Adhesion molecules in radiotherapy. Radiat Res 2006; 166: 819831.
Villani, F, Dell'Oca, I, De Maria, P et al. 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. Anticancer Res 1999; 19: 44754480.
Abratt, RP. Lung toxicity following chest irradiation in patients with lung cancer. Lung Cancer 2002; 35: 103110.
Finkelstein, J, Johnston, CJ, Baggs, R, Rubin, P. Early alterations in extracellular matrix and transforming growth factor beta gene expression in mouse lung indicative of late radiation fibrosis. Int J Radiat Oncol Biol Phys 1994; 28: 621631.
Roman, J. Extracellular matrix and lung inflammation. Immunol Res 1996; 15: 163178.
Vignola, AM, Chanez, P, Chiappara, G et al. Release of transforming growth factor-beta (TGF-beta) and fibronectin by alveolar macrophages in airway diseases. Clin Exp Immunol 1996; 106: 114119.
Ruoslahti, E. Fibronectin and its integrin receptors in cancer. Adv Cancer Res 1999; 76: 120.
Pankov, R, Yamada, KM. Fibronectin at a glance. J Cell Sci 2002; 115: 38613863.
Saba, TM, Jaffe, E. Plasma fibronectin (opsonic glycoprotein): its synthesis by vascular endothelial cells and role in cardiopulmonary integrity after trauma as related to reticuloendothelial function. Am J Med 1980; 68: 577594.
Briggs, SL. The role of fibronectin in fibroblast migration during tissue repair. J Wound Care 2005; 14: 284287.
Romberger, DJ. Molecules in focus - fibronectin. Int J Biochem Cell Biol 1997; 29: 939943.
Zerlauth, G, Wolf, G. Plasma fibronectin as a marker for cancer and other diseases. Am J Med 1984; 77: 685689.
Hegele, A, Heidenreich, A, Kropf, J et al. Plasma levels of cellular fibronectin in patients with localized and metastatic renal cell carcinoma. Tumour Biol 2004; 25: 111116.
Ruelland, A, Kerbrat, P, Clerc, C, Legras, B, Cloarec, L. Level of plasma fibronectin in patients with breast cancer. Clin Chimica Acta 1988; 178: 283287.
Hegele, A, Varga, Z, von Knobloch, R, Olbert, P, Kropf, J, Hofmann, R. Cellular fibronectin plasma and urine levels in human bladder cancer. Eur Urology 2002; 1: 7677.
Ruiz, MG, Prieto, PJ, Veiga de Cabo, J et al. Plasma fibronectin as a marker of sepsis. Int J Infect Dis 2004; 8: 236243.
Pence, S, Yilmaz, G, Yilmaz, N et al. Determination of plasma fibronectin and serum C-reactive protein in patients with cerebrovascular events. Int J Clin 2003; 57: 9195.
Ohke, M, Tada, S, Kataoka, M, Matsuo, K, Nabe, M, Harada, M. Plasma fibronectin in asthmatic patients and its relation to asthma attack. Acta Med Okayama 2001; 55: 9196.
Simo, R, Segura, RM, Garcia-Pascual, L et al. Fibronectin and diabetes mellitus: the factors that influence its plasma concentrations and its usefulness as a marker of late complications. Med Clin 1999; 112: 4550.
Ostlund, E, Hansson, LO, Bremme, K. Fibronectin is a marker for organ involvement and may reflect the severity of preeclampsia. Hypertens Pregnancy 2001; 20: 7987.
Liu, XS, Luo, ZH, Yang, ZC, Li, AN. Clinical significance of the changes in serum fibronectin in severely burned patients. Burns 1996; 22: 295297.
Baluna, R, Sausville, E, Stone, MJ, Stetler-Stevenson, MA, Uhr, J, Vitetta, E. Decreases in levels of serum fibronectin predict the severity of vascular leak syndrome in patients treated with ricin A chain-containing immunotoxins. Clin Cancer Res 1996; 2: 17051711.
Bjermer, L, Hallgren, R, Nilsson, K, Franzen, L, Sandstrom, B, Henriksson, R. Radiation-induced increase in hyaluronan and fibronectin in bronchoalveolar lavage fluid from breast cancer patients is suppressed by smoking. Eur Respir J 1992; 5: 785790.
Barthelemy-Brichant, N, Bosquée, L, Cataldo, D et al. Increased IL-6 and TGF-β1 concentrations in bronchoalveolar lavage fluid associated with thoracic radiotherapy. Int J Radiat Oncol Biol Phys 2004; 58: 758767.
Resnikoff, M, Brien, T, Vincent, PA et al. Lung matrix incorporation of plasma fibronectin reduces vascular permeability in postsurgical bacteremia. Am J Phys 1999; 277: L749L759.
Cox, JD, Stetz, J, Pajak, TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys 1995; 31; 13411346.
Shanker, G, Olson, D, Bone, R, Sawhney, R. Regulation of extracellular matrix proteins by transforming growth factor β1 in cultured pulmonary endothelial cells. Cell Biol Int 1999; 23: 6172.
Nishioka, A, Ogawa, Y, Inomata, T, Maeda, T, Seguchi, H. Fibronectin expression in cancer tissues from patients undergoing radiation therapy. Histol Histopath 1993; 8: 457462.


Radiation-induced toxicity in cancer patients with low plasma fibronectin levels

  • Roxana G. Baluna (a1), Clifton D. Fuller (a2), Tony Y. Eng (a2), Federico L. Ampil (a1) and Charles R. Thomas (a3)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed