Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Maria Skłodowska-Curie National Research Institute of Oncology Gliwice Branch, Poland; Department of Histology, Institute of Medical Sciences, University of Opole, Poland.
Analytics and Clinical Biochemistry Department, Maria Skłodowska-Curie National Research Institute of Oncology Gliwice Branch, Poland.
Radiother Oncol. 2024 Nov;200:110518. doi: 10.1016/j.radonc.2024.110518. Epub 2024 Aug 31.
Osteopontin is a known marker for tumour hypoxia with relevance for the outcome of radiotherapy. We analysed the plasma concentration of OPN in prostate cancer patients receiving RT with or without ADT to evaluate OPN as a potential marker of treatment response.
Between 2012 and 2014, 274 patients with prostate cancer qualifying for RT were enrolled to the study. SCADT received 34.3 % of patients, LCADT 46.3 %. The median OPN concentration was 83.9 ng/mL. We analysed the groups by OPN level: group A with OPN below and group B with OPN above the median.
There was a significant difference in OPN between the Gleason score (p = 0.005), the D'Amico risk (p = 0.002), the ADT (p < 0.001) and the RT (p = 0.019) groups. We found a positive correlation between OPN and clinical stage (p = 0.042). There were no significant effect of OPN on bRFS, RFS and MFS. The 10-year OS rate for group A was 81 % and for group B 60 % (p < 0.001). Cox analysis showed that low OPN level (p < 0.001), low age (p = 0.002) and low Gleason score (p = 0.038) were associated with higher OS. The prognostic influence of OPN on survival decreased with duration of ADT with the strongest effect of OPN (HR=3.93) observed when RT alone was used, weakest effect (HR=2.48) for SCADT and the smallest effect (HR=2.09) for LCADT.
Based on the obtained results, we assume that the level of OPN measured before the start of radiotherapy may be an independent predictor of OS of patients with prostate cancer treated with radiotherapy with and without ADT.
骨桥蛋白(Osteopontin,OPN)是肿瘤乏氧的已知标志物,与放疗疗效相关。我们分析了接受放疗(Radiotherapy,RT)联合或不联合雄激素剥夺治疗(Androgen deprivation therapy,ADT)的前列腺癌患者的血浆 OPN 浓度,以评估 OPN 是否为治疗反应的潜在标志物。
2012 年至 2014 年,共有 274 名符合 RT 条件的前列腺癌患者入组该研究。其中,单纯近距离放疗(Stratified conformal ADT,SCADT)组占 34.3%,低剂量率近距离放疗(Low-dose-rate conformal ADT,LCADT)组占 46.3%。中位 OPN 浓度为 83.9ng/mL。我们根据 OPN 水平将患者分为两组:OPN 水平低于中位数的 A 组和高于中位数的 B 组。
OPN 水平在 Gleason 评分(p=0.005)、D'Amico 风险(p=0.002)、ADT(p<0.001)和 RT(p=0.019)组之间存在显著差异。我们发现 OPN 与临床分期呈正相关(p=0.042)。OPN 对 bRFS、RFS 和 MFS 无显著影响。A 组的 10 年 OS 率为 81%,B 组为 60%(p<0.001)。Cox 分析显示,低 OPN 水平(p<0.001)、低年龄(p=0.002)和低 Gleason 评分(p=0.038)与较高的 OS 相关。OPN 对生存的预后影响随着 ADT 持续时间的延长而降低,当仅使用 RT 时,OPN 的作用最强(HR=3.93),当使用 SCADT 时作用最弱(HR=2.48),当使用 LCADT 时作用最小(HR=2.09)。
根据研究结果,我们假设在开始放疗前测量的 OPN 水平可能是接受放疗联合或不联合 ADT 的前列腺癌患者 OS 的独立预测因子。