A systematic review examining clinical markers and biomarkers of analgesic response to radiotherapy for cancer-induced bone pain

Gardner, Kirstyn; Laird, Barry; Fallon, Marie; Sande, Tonje A.

doi:10.1016/j.critrevonc.2018.10.008

Cited by 13 publications

(11 citation statements)

References 31 publications

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“…In a systematic review, Gardner et al identified eight studies evaluating clinical predictors for RT response. 4,5,7,[9][10][11][33][34][35] Only two studies, both secondary analyses, included several potential predictors in a multivariate analysis. 4,5 Proposed factors in these two studies that could influence response to RT were breast and prostate as the primary cancer, high pain intensity, absence of visceral metastases, younger age, the use of opioids and better performance status.…”

Section: Discussionmentioning

confidence: 99%

“…The present study was designed to in addition to established predictors add the potential predictors radiological appearance of metastases, pain characteristics, depression and inflammation to the model in order to observe if this improves the ability to appropriately select patients for RT. 11 Thus. the aim of this prospective, multicenter study was to investigate which factors are associated with RT response in patients with painful bone metastases.…”

Section: Introductionmentioning

confidence: 92%

“…20 Continuous variables are presented as means with standard deviation (SD) and categorical variables as frequencies with percentages. Potential predictors for RT response were chosen based upon previously described associations, 11 and putative clinical relationship. The 17 independent variables included in analyses are detailed in Table 3.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…12 Different imaging techniques are investigated in respect to RT response in patients with painful bone metastases, but the findings are so far inconclusive. 11 Radiological scans may reveal soft tissue expansions outside bone or classify metastases as osteolytic or osteoblastic (sclerotic). A small trial on spinal bone metastases concluded with no significant difference in analgesic response rates if soft tissue expansions were present.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Predictors for Analgesic Response to Radiotherapy in Patients with Painful Bone Metastases

Habberstad

Frøseth

Aass

et al. 2021

Journal of Pain and Symptom Management

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Background. Radiotherapy (RT) reduces pain in about 60% of patients with painful bone metastases, leaving many patients without clinical benefit. This study assesses predictors for RT effectiveness in patients with painful bone metastases.Materials and methods. We included adult patients receiving RT for painful bone metastases in a multicenter, multinational longitudinal observational study. Pain response within 8 weeks was defined as ≥2-point decrease on a 0À10 pain score scale, without increase in analgesics; or a decrease in analgesics of ≥25% without increase in pain score. Potential predictors were related to patient demographics, RT administration, pain characteristics, tumor characteristics, depression and inflammation (C-reactive protein [CRP]). Multivariate logistic regression analysis with multiple imputation of missing data were applied to identify predictors of RT response.Results. Of 513 eligible patients, 460 patients (90 %) were included in the regression model. 224 patients (44%, 95% confidence interval (CI) 39%À48%) responded to RT. Better Karnofsky performance status (Odds ratio (OR) 1.39, CI 1.15À1.68), breast cancer (OR 2.54, CI 1.12À5.73), prostate cancer (OR 2.83, CI 1.27À6.33) and soft tissue expansion (OR 2.00, CI 1.23À3.25) predicted RT response. Corticosteroids were a negative predictor (OR 0.57, CI 0.37À0.88). Single and multiple fraction RT had similar response. The discriminative ability of the model was moderate; C-statistic 0.69.Conclusion. This study supports previous findings that better performance status and type of cancer diagnosis predicts analgesic RT response, and new data showing that soft tissue expansion predicts RT response and that corticosteroids is a negative

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Predictors for Analgesic Response to Radiotherapy in Patients with Painful Bone Metastases

Habberstad

Frøseth

Aass

et al. 2021

Journal of Pain and Symptom Management

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“…Several studies that have included CIP patients primarily focus on identifying markers that will predict an individual's analgesic response to radiotherapy but limit their analysis to urinary markers of bone turnover and do not address the other modulatory factors that can propagate CIP. [4][5][6][7] Recent research has indicated that cytokines play a key role in mediating cancer pain. 8 Infiltrating pro-inflammatory immune cells found within tumors, as well as cancer cells themselves, release cytokines, which bind to and sensitize neighbouring nociceptors to painful stimuli and elicit a central pain response.…”

Section: Introductionmentioning

confidence: 99%

<p>Applying Serum Cytokine Levels to Predict Pain Severity in Cancer Patients</p>

Fazzari

Sidhu

Motkur

et al. 2020

JPR

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Background and Aim: Cancers originating in the breast, lung and prostate often metastasize to the bone, frequently resulting in cancer-induced bone pain that can be challenging to manage despite conventional analgesic therapy. This exploratory study's aim was to identify potential biomarkers associated with cancer-induced pain by examining a sample population of breast cancer patients undergoing bisphosphonate therapy. Methods: A secondary analysis of the primary study was performed to quantify serum cytokine levels for correlation to pain scores. Cytokines with statistically significant correlations were then input into a stepwise regression analysis to generate a predictive equation for a patient's pain severity. In an effort to find additional potential biomarkers, correlation analysis was performed between these factors and a more comprehensive panel of cytokines and chemokines from breast, lung, and prostate cancer patients. Results: Statistical analysis identified nine cytokines (GM-CSF, IFNγ, IL-1β, IL-2, IL-4, IL-5, IL-12p70, IL-17A, and IL-23) that had significant negative correlations with pain scores and they could best predict pain severity through a predictive equation generated for this specific evaluation. After performing a correlation analysis between these factors and a larger panel of cytokines and chemokines, samples from breast, lung and prostate patients showed distinct correlation profiles, highlighting the clinical challenge of applying pain-associated cytokines related to more defined nociceptive states, such as arthritis, to a cancer pain state. Conclusion: Exploratory analyses such as the ones presented here will be a beneficial tool to expand insights into potential cancer-specific nociceptive mechanisms and to develop novel therapeutics.

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Palliative radiation

Tseng¹

2024

Palliative Radiation Oncology

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A systematic review examining clinical markers and biomarkers of analgesic response to radiotherapy for cancer-induced bone pain

Cited by 13 publications

References 31 publications

Clinical Predictors for Analgesic Response to Radiotherapy in Patients with Painful Bone Metastases

Clinical Predictors for Analgesic Response to Radiotherapy in Patients with Painful Bone Metastases

<p>Applying Serum Cytokine Levels to Predict Pain Severity in Cancer Patients</p>

Palliative radiation

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