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ΑΞΙΟΛΟΓΗΣΗ ΒΙΟΔΕΙΚΤΩΝ ΟΣΤΙΚΟΥ ΜΕΤΑΒΟΛΙΣΜΟΥ ΜΕΤΑ ΑΠΟ ΘΕΡΑΠΕΥΤΙΚΗ ΧΟΡΗΓΗΣΗ ΡΗΝΙΟΥ-186 ΣΤΗΝ ΟΣΤΙΚΗ ΚΑΡΚΙΝΙΚΗ ΝΟΣΟ

Title: ΑΞΙΟΛΟΓΗΣΗ ΒΙΟΔΕΙΚΤΩΝ ΟΣΤΙΚΟΥ ΜΕΤΑΒΟΛΙΣΜΟΥ ΜΕΤΑ ΑΠΟ ΘΕΡΑΠΕΥΤΙΚΗ ΧΟΡΗΓΗΣΗ ΡΗΝΙΟΥ-186 ΣΤΗΝ ΟΣΤΙΚΗ ΚΑΡΚΙΝΙΚΗ ΝΟΣΟ

Doctoral Thesis / Dissertation , 2009 , 142 Pages

Autor:in: Dr Athanasios Zafeirakis (Author)

Medicine - Neoplasms, Oncology
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Summary Excerpt Details

Purpose: To prospectively evaluate the predictive value of various bone formation and resorption makers in patients with bone metastases from prostate cancer after palliative therapies with 186Rhenium-l,l-hydroxyethylidene diphosphonate (186Re-HEDP).
Methods: Thirty six males with prostate cancer, suffering from painful osseous metastases and treated with 186Rhenium-HEDP, were studied. None had received therapies that interfere with bone metabolism before 186Rhenium-HEDP therapy and throughout the follow-up period. For each patient, pre-therapy and post-therapy serum levels of osteocalcin (OC), bone alkaline phosphatase (BALP), amino-terminal (PINP) and carboxy-terminal (PICP) propeptides of type I collagen, amino-terminal (NTx) and carboxy-terminal (CTx) telopeptides of type I collagen and their combinations were compared to the level and duration of pain response to radionuclide therapies.
Results: Pain response was correlated only with pre-treatment values of ΝΤx/PINP, PICP/PINP and NTx/CTx ratios and post-treatment decrease of baseline NTx and PICP values (P=0.0025-0.035). According to multivariate and ROC analyses, the best marker-derived predictors of better and longer duration of response to 186Rhenium-HEDP therapies proved post-therapy drop of NTx ≥20% (RR=3.44, P=0.0005) and pre-therapy NTx/PINP ≥1.2 (RR=3.04, P=0.036)
Conclusions: NTx, a potent collagenous marker of bone resorption, along with the novel NTx/PINP ratio provide useful cut-off values for identifying a group of patients suffering from painful osseous metastases from HRPC, who will not respond to palliative treatments with 186Rhenium-HEDP. This information could prevent an inefficient and expensive radionuclide therapy. Also, in the cohort of patients who will eventually undergo such treatments, the middle-term post-therapy changes of NTx offer valuable predictive information regarding long-term palliative response.

Excerpt


Inhaltsverzeichnis

  • Einleitung
  • Methoden
    • Studienpopulation
    • Untersuchungsdesign
    • Datenerhebung
    • Datenanalyse
  • Ergebnisse
    • Ergebnisse der Studiengruppe
    • Ergebnisse der Kontrollgruppe
  • Diskussion
  • Schlussfolgerungen

Zielsetzung und Themenschwerpunkte

Diese Arbeit zielt darauf ab, den Zusammenhang zwischen Biomarkern des Knochenstoffwechsels und der therapeutischen Anwendung von Radioisotopen bei der Behandlung von Knochenkrebs zu untersuchen. Sie untersucht die Veränderungen im Knochenstoffwechsel nach der Radioisotopentherapie und die Auswirkungen auf die Patienten.

  • Der Einfluss von Radioisotopen auf den Knochenstoffwechsel
  • Die Analyse von Biomarkern, die den Knochenstoffwechsel widerspiegeln
  • Die Bewertung der Wirksamkeit der Radioisotopentherapie
  • Die Identifizierung von potenziellen Risiken und Komplikationen
  • Die Verbesserung des Verständnisses der Pathophysiologie von Knochenkrebs

Zusammenfassung der Kapitel

Die Einleitung bietet einen umfassenden Überblick über die Knochenkrebstherapie und die Rolle von Radioisotopen. Sie beschreibt die Bedeutung des Knochenstoffwechsels und die Rolle von Biomarkern bei der Überwachung der Therapie. Das Kapitel Methoden erklärt das Studienprotokoll, die Studiengruppe, die Kontrollgruppe, die Datenerhebung und die statistischen Methoden, die verwendet wurden. Die Ergebnisse präsentieren die gefundenen Daten in Bezug auf den Knochenstoffwechsel, die Veränderungen nach der Radioisotopentherapie und die Auswirkungen auf die Patienten. Die Diskussion interpretiert die Ergebnisse und setzt sie in den Kontext des bestehenden Wissensstandes. Die Schlussfolgerungen fassen die wichtigsten Ergebnisse zusammen und geben Empfehlungen für zukünftige Forschung.

Schlüsselwörter

Knochenkrebs, Radioisotopentherapie, Knochenstoffwechsel, Biomarker, Therapieüberwachung, Wirksamkeit, Risiken, Komplikationen, Pathophysiologie.

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Details

Title
ΑΞΙΟΛΟΓΗΣΗ ΒΙΟΔΕΙΚΤΩΝ ΟΣΤΙΚΟΥ ΜΕΤΑΒΟΛΙΣΜΟΥ ΜΕΤΑ ΑΠΟ ΘΕΡΑΠΕΥΤΙΚΗ ΧΟΡΗΓΗΣΗ ΡΗΝΙΟΥ-186 ΣΤΗΝ ΟΣΤΙΚΗ ΚΑΡΚΙΝΙΚΗ ΝΟΣΟ
College
National & Kapodistrian University of Athens  (ΕΘΝΙΚΟ ΚΑΙ ΚΑΠΟΔΙΣΤΡΙΑΚΟ ΠΑΝΕΠΙΣΤΗΜΙΟ ΑΘΗΝΩΝ - Α' ΕΡΓΑΣΤΗΡΙΟ ΑΚΤΙΝΟΛΟΓΙΑΣ)
Author
Dr Athanasios Zafeirakis (Author)
Publication Year
2009
Pages
142
Catalog Number
V138826
ISBN (eBook)
9783640484690
ISBN (Book)
9783640484492
Language
Greek, Modern (1453-)
Product Safety
GRIN Publishing GmbH
Quote paper
Dr Athanasios Zafeirakis (Author), 2009, ΑΞΙΟΛΟΓΗΣΗ ΒΙΟΔΕΙΚΤΩΝ ΟΣΤΙΚΟΥ ΜΕΤΑΒΟΛΙΣΜΟΥ ΜΕΤΑ ΑΠΟ ΘΕΡΑΠΕΥΤΙΚΗ ΧΟΡΗΓΗΣΗ ΡΗΝΙΟΥ-186 ΣΤΗΝ ΟΣΤΙΚΗ ΚΑΡΚΙΝΙΚΗ ΝΟΣΟ, Munich, GRIN Verlag, https://www.grin.com/document/138826
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Excerpt from  142  pages
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