Chen Lin, Zhu Weina, Zhu Shenghao, Ding Quanhua
Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200080, China.
Department of Pharmacy, Hwa Mei Hospital, University of Chinese Academy of Sciences Ningbo 315000, Zhejiang, China.
Am J Transl Res. 2022 Sep 15;14(9):6669-6677. eCollection 2022.
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.
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.
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).
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.
探讨阿仑膦酸钠联合局部放疗对原发性肝癌骨转移患者血清Akt/GSK3β水平及骨代谢的影响。
回顾性分析上海交通大学医学院附属上海第一人民医院收治的68例原发性肝癌骨转移患者的临床资料。根据手术方式不同，将患者分为对照组33例，采用局部放疗联合盐酸羟考酮缓释片治疗；研究组35例，采用阿仑膦酸钠联合局部放疗治疗。比较两组的缓解率和不良反应发生率。此外，观察并比较两组患者治疗前后的肝功能指标（总胆红素（TBIL）、谷丙转氨酶（ALT）和碱性磷酸酶（ALP））、血清Akt/GSK3β水平、骨代谢水平（骨碱性磷酸酶（BAP）和骨钙素（OST）水平）、甲胎蛋白（AFP）、血管内皮生长因子（VEGF）、骨桥蛋白（OPN）、基质金属蛋白酶9（MMP-9）及生活质量。
研究组缓解率（94.29%）高于对照组（75.76%）（P<0.05）。研究组不良反应发生率（20.00%）与对照组（12.12%）比较，差异无统计学意义（P>0.05）。两组治疗后血清TBIL、ALT、ALP、Akt、GSK3β、AFP、VEGF、OPN、MMP-9水平及癌症所致的痛苦和恶心均降低，而血清BAP和OST水平及心理、身体和社会功能均升高（均P<0.05）。研究组上述指标的改善情况优于对照组（均P<0.05）。
阿仑膦酸钠联合局部放疗治疗原发性肝癌骨转移患者疗效良好。此外，患者肝功能、骨代谢水平及生活质量均得到改善，且未增加不良反应。其潜在机制可能与Akt和GSK3β水平的调节有关。
