Paal Katarzyna, Stranz Bettina, Thurner Eva-Maria, Niedrist Tobias, Renner Wilfried, Langsenlehner Tanja
Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria.
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036, Graz, Austria.
World J Urol. 2024 Dec 18;43(1):35. doi: 10.1007/s00345-024-05409-z.
The present study was performed to investigate the association of prostate cancer radiotherapy with inflammaging, a condition characterized by the elevation of inflammatory blood parameters that significantly increases the susceptibility to the occurrence or progression of age-related conditions.
A total of 306 patients treated with curative radiotherapy (RT) for prostate cancer were enrolled into the prospective study. Aging-related inflammatory parameters including C-reactive protein (CRP), albumin, fibrinogen, cholesterol, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were analyzed before and at the end of RT, and 3 and 15 months after completion of the RT. Statistical analysis was performed using non-parametric variance analysis.
Overall variance analysis showed a significant influence of RT on all inflammatory parameters (p < 0.001) with the exception of CRP (p = 0.498). Pairwise analysis revealed a significant elevation of fibrinogen (p = 0.041), NLR (p < 0.001), and PLR levels (p < 0.001) as well as a significant decrease of albumin (p < 0.001) and cholesterol levels (p < 0.001) during the RT course. After completion of RT, a significant recovery was detected for NLR, PLR, albumin and cholesterol. However, 15 months after RT, PLR, fibrinogen, and cholesterol remained significantly lower when compared to the baseline (p < 0.001).
Our results indicate that radiation therapy triggers chronic inflammatory processes that could contribute to the development, acceleration or worsening of age-related alterations and conditions. Further investigations to estimate the long-term consequences of curative radiation therapy on clinical manifestations of aging are warranted.
本研究旨在探讨前列腺癌放疗与炎症衰老之间的关联，炎症衰老的特征是血液炎症参数升高，这会显著增加患年龄相关疾病或疾病进展的易感性。
共有306例接受前列腺癌根治性放疗（RT）的患者纳入本前瞻性研究。在放疗前、放疗结束时以及放疗完成后3个月和15个月，分析与衰老相关的炎症参数，包括C反应蛋白（CRP）、白蛋白、纤维蛋白原、胆固醇、血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值（NLR）。采用非参数方差分析进行统计分析。
总体方差分析显示，除CRP外（p = 0.498），放疗对所有炎症参数均有显著影响（p < 0.001）。两两分析显示，在放疗过程中，纤维蛋白原（p = 0.041）、NLR（p < 0.001）和PLR水平显著升高（p < 0.001），白蛋白（p < 0.001）和胆固醇水平显著降低（p < 0.001）。放疗完成后，NLR、PLR、白蛋白和胆固醇有显著恢复。然而，放疗后15个月，与基线相比，PLR、纤维蛋白原和胆固醇仍显著降低（p < 0.001）。
我们的结果表明，放射治疗会引发慢性炎症过程，这可能导致年龄相关改变和疾病的发生、加速或恶化。有必要进一步研究以评估根治性放射治疗对衰老临床表现的长期影响。
