Effects of alendronate combined with local radiotherapy on serum Akt/GSK3β and bone metabolism levels in patients with bone metastases from primary liver cancer.

OBJECTIVE

To investigate the effects of alendronate combined with local radiotherapy on the level of serum Akt/GSK3β and bone metabolism in patients of primary liver cancer with bone metastases.

METHODS

Clinical data of 68 patients of primary liver cancer with bone metastases and treated in Shanghai General Hospital, a hospital affiliated to Shanghai Jiao Tong University School of Medicine, were retrospectively analyzed. According to the different surgical methods, the patients were divided into a control group, with 33 cases treated with local radiotherapy plus Oxycodone hydrochloride extended-release tablets, and a study group, with 35 cases treated with alendronate combined with local radiotherapy. The remission rate and adverse reaction rate were compared between the two groups. In addition, we observed and compared the liver function indexes (total bilirubin (TBIL), alanine aminotransferase (ALT) and alkaline phosphatase (ALP)), serum Akt/GSK3β level, bone metabolism levels (bone alkaline phosphatase (BAP) and levels of osteocalcin (OST)), α-fetoprotein (AFP), vascular endothelial growth factor (VEGF), osteopontin (OPN), matrix metallopeptidase 9 (MMP-9), and quality of life of the patients in two groups before and after treatment.

RESULTS

A higher remission rate was observed in the study group (94.29%) than that in the control group (75.76%) (P<0.05). There was no significant difference in the adverse reaction rate between the study group (20.00%) and the control group (12.12%) (P>0.05). In both groups, the post-treatment serum levels of TBIL, ALT, ALP, Akt, GSK3β, AFP, VEGF, OPN, MMP-9, hardship and nausea due to cancer were all decreased, while serum levels of BAP and OST, and psychological, physical and social functions were all increased (all P<0.05). The improvement of the above indicators in the study group were better than those in the control group (all P<0.05).

CONCLUSION

The use of alendronate combined with local radiotherapy received good response in patients of primary liver cancer with bone metastasis. In addition, their liver function, bone metabolism levels and quality of life all improved without increasing adverse reactions. The underlying mechanism may be related to the regulation of Akt and GSK3β levels.