European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU (R.H., P.K.), Norwegian University of Science and Technology and St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway; Cancer Clinic, St. Olavs hospital (R.H.), Trondheim University Hospital, Trondheim, Norway.
European Palliative Care Research Centre (PRC), Department of Oncology (N.A., S.K.), Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
J Pain Symptom Manage. 2022 Oct;64(4):330-339. doi: 10.1016/j.jpainsymman.2022.06.018. Epub 2022 Jul 5.
Inflammation is proposed to influence tumor response in radiotherapy (RT). Clinical studies to investigate the relationship between inflammatory markers and RT response is warranted to understand the variable RT efficacy in patients with painful bone metastases.
To evaluate the association between inflammatory markers and analgesic response to RT in patients with painful bone metastases.
Adult patients from 7 European study sites undergoing RT for painful bone metastases were included in this prospective and longitudinal analysis. The association between RT response and 17 inflammatory markers at baseline, as well as the association between RT response and the changes observed in inflammatory markers between baseline and three and eight weeks after RT, was analyzed with univariate regression analyses. Baseline analyses were adjusted for potential clinical predictors of RT response.
None of the inflammatory markers were significantly associated with an upcoming RT response in the analysis of 448 patients with complete baseline data. In patients available for follow-up, the three-week change in TNF (P 0.017), IL-8 (P 0.028), IP-10 (P 0.032), eotaxin (P 0.043), G-CSF (P 0.033) and MCP-1 (P 0.002) were positively associated with RT response, while the three-week change in CRP (P 0.006) was negatively associated.
Results from this study show an association between RT response and change in pro-inflammatory mediators and indicate that inflammation may be important to achieve an analgesic RT response in patients with painful bone metastases. None of the investigated inflammatory markers were found to be pre-treatment predictors of RT response.
炎症被认为会影响放射治疗（RT）的肿瘤反应。有必要进行临床研究来探讨炎症标志物与 RT 反应之间的关系，以了解在患有骨转移疼痛的患者中 RT 疗效的可变性。
评估炎症标志物与接受 RT 治疗的骨转移疼痛患者的镇痛反应之间的关系。
本前瞻性纵向分析纳入了来自欧洲 7 个研究点正在接受 RT 治疗骨转移疼痛的成年患者。使用单变量回归分析，分析了 RT 反应与基线时的 17 种炎症标志物之间的关联，以及 RT 反应与 RT 前后 3 周和 8 周之间观察到的炎症标志物变化之间的关联。基线分析针对 RT 反应的潜在临床预测因素进行了调整。
在对 448 例基线数据完整的患者进行的分析中，没有一种炎症标志物与即将到来的 RT 反应显著相关。在可进行随访的患者中，3 周时 TNF（P 0.017）、IL-8（P 0.028）、IP-10（P 0.032）、嗜酸性粒细胞趋化因子（eotaxin）（P 0.043）、G-CSF（P 0.033）和 MCP-1（P 0.002）的变化与 RT 反应呈正相关，而 C 反应蛋白（CRP）的变化（P 0.006）与 RT 反应呈负相关。
本研究结果表明 RT 反应与促炎介质的变化之间存在关联，并表明炎症可能对患有骨转移疼痛的患者获得镇痛 RT 反应很重要。在接受 RT 治疗的患者中，没有发现任何一种研究中的炎症标志物是治疗反应的预测因素。
