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

abstract

  • PURPOSE: 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. METHODS AND MATERIALS: 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. RESULTS: During fractionated radiotherapy, citrulline concentration significantly decreased as a function of the radiation dose (p < 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. CONCLUSIONS: 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.

published proceedings

  • Int J Radiat Oncol Biol Phys

altmetric score

  • 3

author list (cited authors)

  • Lutgens, L., Deutz, N., Granzier-Peeters, M., Beets-Tan, R., De Ruysscher, D., Gueulette, J., ... Lambin, P.

citation count

  • 104

complete list of authors

  • Lutgens, Ludy CHW||Deutz, Nicolaas||Granzier-Peeters, Marlies||Beets-Tan, Regina||De Ruysscher, Dirk||Gueulette, John||Cleutjens, Jack||Berger, Martijn||Wouters, Bradly||von Meyenfeldt, Maarten||Lambin, Philippe

publication date

  • September 2004