Open AccessEfficacy of radiation treatment in combination with COX-2 inhibitor in patients with NSCLC
Author(s) -
N. V. Bilozor,
Viktor Starenkiy,
N. A. Mitryayeva,
L. V. Grebinyk
Publication year - 2020
Publication title -
ukraïnsʹkij radìologìčnij ta onkologìčnij žurnal
Language(s) - English
Resource type - Journals
eISSN - 2708-7174
pISSN - 2708-7166
DOI - 10.46879/ukroj.2.2020.106-117
Subject(s) - subgroup analysis , medicine , proportional hazards model , lung cancer , gastroenterology , oncology , carcinoma , stage (stratigraphy) , survival analysis , confidence interval , paleontology , biology
Background. COX-2 inhibitors facilitate disruption of the production of angiogenic factors, the use of which in combination with RT leads to a significant delay in tumor growth in experimental models of cancer.
Purpose. Evaluation of the effectiveness of RT in combination with COX-2 inhibitor in patients with NSCLC (non-small-cell lung carcinoma).
Materials and methods. The study involved 38 patients with NSCLC divided into 2 subgroups: Subgroup 1 was represented by 20 patients who received a RT course and celecoxib 100 mg/d, Subgroup 2 enrolled 18 patients who received only RT. The subgroups were comparable by sex, age, tumor location, general condition. Squamous cell carcinoma was detected in 19 (95.0%) patients of Subgroup 1 and in 9 (50%) patients of Subgroup 2. Stages I – II were diagnosed 4.4 times more frequently in Subgroup 2, stage III was 1.9 times more frequently detected in Subgroup 1 (p < 0.05).
VEGF, COX-2 content was assessed before/after the RT course by means of a sandwich immunoassay (ELISA).
Results. A positive effect (partial regression, stabilization) was observed equally in the subgroups: 80.0% and 77.8%. In Subgroup 1, partial regression was 5 times more frequent, the overall annual and recurrence-free survival increased by 15 and 29%, respectively.
In patients of Subgroup 1, COX-2 was 2.4-fold decreased, in patients of Subgroup 2, COX-2 almost did not change. COX-2 blocking was accompanied by decreased VEGF: 1.9-fold in Subgroup 1, 1.4-fold in Subgroup 2. Changes in COX-2 and VEGF levels were consistent with the objective response after RT with celecoxib: in case of a positive effect, COX-2 level was significantly decreasing (2.3-1.9-fold), VEGF level was significantly decreasing (2.3–1.7-fold); progressive tumor growth was combined with a minor decrease in COX-2 and VEGF (1.5–1.4-fold).
Conclusions. Radiation therapy in combination with COX-2 inhibitor enhances the effectiveness of treatment by increasing partial regressions and relapse-free survival. An objective response correlates with COX-2 and VEGF levels, which makes it possible to use them to assess RT effectiveness and decide on further treatment strategy.