title: Evaluation of Bone Metastasis Using Serial Measurements of Serum N-Telopeptides of Type I Collagen in Patients with Lung Cancer: A Prospective Study.
abstract: OBJECTIVE
  The bone resorption biomarker cross-linked N-Telopeptides of type I collagen (NTx) has been shown to aid in the diagnosis of metastatic bone disease from lung cancer (MBDLC). Patients with MBDLC are often treated with zoledronic acid (ZA). ZA reduces the levels of NTx and also lowers the risk of skeletal adverse events in patients with MBDLC.
  
  
  METHODS
  Patients with MBDLC at initial diagnosis were included in the study. NTx was measured in serum (sNTx) once a month using the OSTEOMARKTM sNTx assay. MBDLC was assessed by monthly physical examinations and bone scintigraphy every 3 months for 12 months.
  
  
  RESULTS
  Twenty patients were enrolled between June and December 2010. The sNTx concentration at baseline was 19.8 ± 5.8 nmol bone collagen equivalents (nmol BCE)/l. In the 16 patients receiving ZA, the level of sNTx significantly decreased after the first month of treatment (baseline vs. 1 month of treatment: 21.3 ± 5.5 vs. 13.6 ± 2.7 nmol BCE/l; p<0.01). During the follow-up period, 13 of the patients treated with ZA experienced worsening of bone metastasis. There were statistically significant differences in the levels of sNTx at baseline (20.3 ± 4.8 nmol BCE/l), at the lowest levels after administration of ZA (11.8 ± 2.9 nmol BCE/l vs. baseline; p<0.001), and at the time of measurable disease progression (14.1 ± 4.6 nM BCE/l vs. baseline; p<0.05).
  
  
  CONCLUSIONS
  Serial measurements of sNTx in patients with MBDLC treated with ZA may effectively predict disease progression.
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan moto19781205@yahoo.co.jp.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tamiya
authors.affiliation: Department of Clinical Oncology, Osaka City General Hospital, Miyakojimaku, Osaka, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tokunaga
authors.affiliation: Department of Clinical Oncology, Osaka City General Hospital, Miyakojimaku, Osaka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Thoracic Oncology, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Sasada
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Okamoto
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Morishita
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shiroyama
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Otsuka
authors.affiliation: Department of Clinical Oncology, Osaka City General Hospital, Miyakojimaku, Osaka, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Miyamoto
authors.affiliation: Department of Clinical Oncology, Osaka City General Hospital, Miyakojimaku, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Taira
authors.affiliation: Department of Clinical Oncology, Osaka City General Hospital, Miyakojimaku, Osaka, Japan.
authors.forename: Haruko
authors.initials: H
authors.lastname: Daga
authors.affiliation: Department of Clinical Oncology, Osaka City General Hospital, Miyakojimaku, Osaka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Hospital Organization, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000097:blood* / Q000473:pathology; D024042:Collagen Type I / Q000097:blood*; D004164:Diphosphonates / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D011446:Prospective Studies; D000077211:Zoledronic Acid
chemical_list: D024042:Collagen Type I; D004164:Diphosphonates; D007093:Imidazoles; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000077211:Zoledronic Acid
keywords: Cross-linked N-Telopeptides of type I collagen; NTx; bone metastasis; lung cancer