Edward Chow1, Carlo DeAngelis2, Bingshu E Chen3, Azar Azad4, Ralph M Meyer5, Carolyn Wilson3, Marc Kerba6, Andrea Bezjak7, Paula Wilson8, Abdenour Nabid9, Jonathan Greenland10, Gareth Rees11, Reinhold Vieth4, Rebecca K S Wong7, Peter Hoskin12. 1. Sunnybrook Odette Cancer Centre, University of Toronto, Canada. Electronic address: Edward.Chow@sunnybrook.ca. 2. Sunnybrook Odette Cancer Centre, University of Toronto, Canada. 3. NCIC Clinical Trials Group, Cancer Research Institute, Queen's University, Kingston, Canada. 4. Mount Sinai Hospital, University of Toronto, Canada. 5. Juravinski Hospital and Cancer Centre and McMaster University, Hamilton, Canada. 6. Tom Baker Cancer Centre, University of Calgary, Canada. 7. Princess Margaret Hospital, Ontario Cancer Institute, University of Toronto, Canada. 8. Bristol Haematology & Oncology Centre, UK. 9. Centre Hospitalier Universitaire de Sherbrooke, Canada. 10. Eastern Health, Division of Radiation Oncology, St. John's, Canada. 11. Royal United Hospital, Bath, UK. 12. Mount Vernon Hospital Cancer Centre, Northwood, UK.
Abstract
PURPOSE: The NCIC CTG Symptom Control.20 randomized trial (SC.20) confirmed the effectiveness of re-irradiation to painful bone metastases. This companion study correlates urinary markers of osteoclast activity with response to re-irradiation, survival and skeletal related events (SREs). METHODS:Pain response was assessed using the International Consensus Endpoints. Urinary markers of bone turnover-pyridinoline (PYD), deoxypyridinoline (DPD), N-telopeptide (NTX), Alpha and Beta cross-laps of C-telopeptide (CTX)-before and 1month after re-irradiation were correlated to response to re-irradiation and then to both, either or none of the initial and re-irradiation: frequent responders (response to both); eventual responders (response to re-irradiation only); eventual non-responders (response to initial radiation only), and absolute non-responders (no response to both). RESULTS: Significant differences between 40 responders and 69 non-responders to re-irradiation existed for PYD (p=0.03) and DPD (p=0.04) at baseline. When patients were categorized as frequent responders (N=34), eventual responders (6), eventual non-responders (59) and absolute non-responders (10), the mean values of all markers in the absolute non-responders at baseline and the follow-up were about double those for the other three groups with statistically significant difference for DPD (p=0.03) at baseline. Absolute non-responders had the worst survival. The few occurrences of the SREs did not allow meaningful comparisons among the groups. CONCLUSION: There were significant differences between responders and non-responders to re-irradiation for PYD and DPD at baseline. The urinary markers in the absolute non-responders were markedly elevated at both baseline and follow-up with a statistically significant difference for DPD at baseline.
RCT Entities:
PURPOSE: The NCIC CTG Symptom Control.20 randomized trial (SC.20) confirmed the effectiveness of re-irradiation to painful bone metastases. This companion study correlates urinary markers of osteoclast activity with response to re-irradiation, survival and skeletal related events (SREs). METHODS:Pain response was assessed using the International Consensus Endpoints. Urinary markers of bone turnover-pyridinoline (PYD), deoxypyridinoline (DPD), N-telopeptide (NTX), Alpha and Beta cross-laps of C-telopeptide (CTX)-before and 1month after re-irradiation were correlated to response to re-irradiation and then to both, either or none of the initial and re-irradiation: frequent responders (response to both); eventual responders (response to re-irradiation only); eventual non-responders (response to initial radiation only), and absolute non-responders (no response to both). RESULTS: Significant differences between 40 responders and 69 non-responders to re-irradiation existed for PYD (p=0.03) and DPD (p=0.04) at baseline. When patients were categorized as frequent responders (N=34), eventual responders (6), eventual non-responders (59) and absolute non-responders (10), the mean values of all markers in the absolute non-responders at baseline and the follow-up were about double those for the other three groups with statistically significant difference for DPD (p=0.03) at baseline. Absolute non-responders had the worst survival. The few occurrences of the SREs did not allow meaningful comparisons among the groups. CONCLUSION: There were significant differences between responders and non-responders to re-irradiation for PYD and DPD at baseline. The urinary markers in the absolute non-responders were markedly elevated at both baseline and follow-up with a statistically significant difference for DPD at baseline.
Authors: Jennifer Fazzari; Jesse Sidhu; Shreya Motkur; Mark Inman; Norman Buckley; Mark Clemons; Lisa Vandermeer; Gurmit Singh Journal: J Pain Res Date: 2020-02-07 Impact factor: 3.133
Authors: Ragnhild Habberstad; Trude Camilla Salvesen Frøseth; Nina Aass; Tatiana Abramova; Theo Baas; Siri Tessem Mørkeset; Augusto Caraceni; Barry Laird; Jason W Boland; Romina Rossi; Elena Garcia-Alonso; Hanne Stensheim; Jon Håvard Loge; Marianne Jensen Hjermstad; Ellen Bjerkeset; Asta Bye; Jo-Åsmund Lund; Tora Skeidsvoll Solheim; Ola Magne Vagnildhaug; Cinzia Brunelli; Jan Kristian Damås; Tom Eirik Mollnes; Stein Kaasa; Pål Klepstad Journal: BMC Palliat Care Date: 2018-09-28 Impact factor: 3.234