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Predictive and prognostic value of circulating nucleosomes and serum biomarkers in patients with metastasized colorectal cancer undergoing Selective Internal Radiation Therapy.
- Source :
-
BMC cancer [BMC Cancer] 2012 Jan 04; Vol. 12, pp. 5. Date of Electronic Publication: 2012 Jan 04. - Publication Year :
- 2012
-
Abstract
- Background: Selective Internal Radiation Therapy (SIRT) is a new and effective locoregional anticancer therapy for colorectal cancer patients with liver metastases. Markers for prediction of therapy response and prognosis are needed for the individual management of those patients undergoing SIRT.<br />Methods: Blood samples were prospectively and consecutively taken from 49 colorectal cancer patients with extensive hepatic metastases before, three, six, 24 and 48 h after SIRT to analyze the concentrations of nucleosomes and further laboratory parameters, and to compare them with the response to therapy regularly determined 3 months after therapy and with overall survival.<br />Results: Circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), carcinoembryonic antigen (CEA), C-reactive protein (CRP) and various liver markers increased already 24 h after SIRT. Pretherapeutical levels of CYFRA 21-1, CEA, cancer antigen 19-9 (CA 19-9), asparate-aminotransferase (AST) and lactate dehydrogenase (LDH) as well as 24 h values of nucleosomes were significantly higher in patients suffering from disease progression (N = 35) than in non-progressive patients (N = 14). Concerning overall survival, CEA, CA 19-9, CYFRA 21-1, CRP, LDH, AST, choline esterase (CHE), gamma-glutamyl-transferase, alkaline phosphatase, and amylase (all 0 h, 24 h) and nucleosomes (24 h) were found to be prognostic relevant markers in univariate analyses. In multivariate Cox-Regression analysis, the best prognostic model was obtained for the combination of CRP and AST. When 24 h values were additionally included, nucleosomes (24 h) further improved the existing model.<br />Conclusion: Panels of biochemical markers are helpful to stratify pretherapeutically colorectal cancer patients for SIR-therapy and to early estimate the response to SIR-therapy.
- Subjects :
- Adult
Aged
Cohort Studies
Female
Humans
Kaplan-Meier Estimate
Liver Neoplasms blood
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prognosis
Prospective Studies
Radiopharmaceuticals therapeutic use
Survival Analysis
Technetium Tc 99m Medronate therapeutic use
Biomarkers, Tumor blood
Colorectal Neoplasms blood
Colorectal Neoplasms mortality
Liver Neoplasms radiotherapy
Liver Neoplasms secondary
Nucleosomes metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2407
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- BMC cancer
- Publication Type :
- Academic Journal
- Accession number :
- 22216763
- Full Text :
- https://doi.org/10.1186/1471-2407-12-5