Τίτλος:
Predictive implications of bone turnover markers after palliative
treatment with Re-186-HEDP in hormone-refractory prostate cancer
patients with painful osseous metastases
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
To prospectively evaluate the predictive value of various bone formation
and resorption markers in patients with bone metastases from prostate
cancer after palliative treatment with Re-186-1,1-hydroxyethylidene
diphosphonate (Re-186-HEDP).
Included in the study were 36 men with prostate cancer, suffering from
painful osseous metastases and treated with Re-186-HEDP. None had
received any treatment that would have interfered with bone metabolism
before Re-186-HEDP treatment or throughout the follow-up period. For
each patient, pretreatment and posttreatment serum levels of osteocalcin
(OC), bone alkaline phosphatase (BALP), aminoterminal (PINP) and
carboxyterminal (PICP) propeptides of type I collagen, amino-terminal
(NTx) and carboxyterminal (CTx) telopeptides of type I collagen and
their combinations were compared with the level and duration of pain
response to radionuclide treatment.
Pain response was correlated only with pretreatment IeIcurrency
signx/PINP, PICP/PINP and NTx/CTx ratios and posttreatment decrease in
baseline NTx and PICP values (p=0.0025-0.035). According to multivariate
and ROC analyses, the best marker-derived predictors of better and
longer duration of response to Re-186-HEDP treatment were a
posttreatment decrease in NTx of a parts per thousand yen20% (RR=3.44,
p=0.0005) and a pretreatment NTx/PINP ratio of a parts per thousand
yen1.2 (RR=3.04, p=0.036)
NTx, a potent collagenous marker of bone resorption, along with the
novel NTx/PINP ratio provide useful cut-off values for identifying a
group of patients suffering from painful osseous metastases from
hormone-refractory prostatic carcinoma who do not respond to palliative
treatment with Re-186-HEDP. This information could help avoid an
inefficient and expensive radionuclide treatment. Also, in the cohort of
patients who will eventually undergo such treatment, the medium-term
posttreatment changes in NTx offer valuable predictive information
regarding long-term palliative response.
Συγγραφείς:
Zafeirakis, Athanasios
Papatheodorou, Georgios
Arhontakis,
Athanasios
Gouliamos, Athanasios
Vlahos, Lambros
Limouris,
Georgios S.
Περιοδικό:
European Journal of Nuclear Medicine and Molecular Imaging
Λέξεις-κλειδιά:
Prostate cancer; Bone metastases; Bone pain; Bone turnover markers;
Palliative therapies; Re-186
DOI:
10.1007/s00259-009-1243-5
