Urine calcium and deoxypyridinoline in assessment of response to local radiation therapy for metastatic bone disease.
To evaluate the predictability of urine calcium (Ca+2) and deoxypyridinoline (DPD) in the assessment of response to palliative radiation therapy (RT) for metastatic bone disease. Forty-two patients with osteolytic bone metastases from breast or lung primaries were enrolled in this study. Serial urine Ca+2 and DPD measurements were performed before RT, six weeks, and twelve weeks afterwards. All eligible patients received a total of 30 Gy RT in 3 Gy daily fractions. Pre-irradiation mean urine Ca+2 and DPD levels were 16 +/- 3.7 g/micromol/dL, and 89.2 +/- 61 pmol/micromol crea. Both were significantly higher than normal range. A significant correlation between pre-irradiation Ca+2 (r = 0.6, p < 0.001), DPD (r = 0.8, p < 0.001) levels and the extent of bone metastases were detected. Thirty-six patients (Group I) were alive without disease progression outside the radiation portal. Urine Ca+2 and DPD levels demonstrated a significant and progressive decrease following RT in Group I patients (p < 0.001). Clinical and radiological evaluation revealed occurrence of new bone metastases in six patients (Group II), with concurrent significant increase in concentrations of urine DPD and Ca+2 (p = 0.006 for Ca+2 and p = 0.009 for DPD, respectively). Urine Ca+2 and DPD levels can be used for assessment of response of bone to local irradiation, and are able to predict further progression of bone metastases in cancer patients.
Topkan
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Department of Radiation Oncology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey. drerkantopkan@yahoo.com
Karaoglu
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000652:urine*; D014408:Biomarkers, Tumor / Q000652:urine*; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002118:Calcium / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D000596:Amino Acids; D014408:Biomarkers, Tumor; C036020:deoxypyridinoline; D002118:Calcium