Reliability of Alkaline Phosphatase for Differentiating Flare Phenomenon from Disease Progression with Bone Scintigraphy

Cancers

Jaetae Lee¹  Chae-Moon Hong¹  Byeong-Cheol Ahn¹  Il Jo¹  Sang-Woo Lee¹  Shin-Young Jeong¹  Ji-hoon Jung² 

[1] Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea;Department of Radiology, College of Medicine, Hanyang University Guri Hospital, Guri 11923, Korea;

关键词: bone scintigraphy;    flare phenomenon;    alkaline phosphatase;    bone metastasis;    breast cancer;    prostate cancer;   

DOI  :  10.3390/cancers14010254

来源: DOAJ

【 摘 要 】

The flare phenomenon (FP) on bone scintigraphy after the initiation of systemic treatment seriously complicates evaluations of therapeutic response in patients with bone metastases. The aim of this study was to evaluate whether serum alkaline phosphatase (ALP) can differentiate FP from disease progression on bone scintigraphy in these patients. Breast or prostate cancer patients with bone metastases who newly underwent systemic therapy were reviewed. Pretreatment baseline and follow-up data, including age, pathologic factors, type of systemic therapy, radiologic and bone scintigraphy findings, and ALP levels, were obtained. Univariate and multivariate analyses of these factors were performed to predict FP. An increased extent and/or new lesions were found in 160 patients on follow-up bone scintigraphy after therapy. Among the 160 patients, 80 (50%) had an improvement on subsequent bone scintigraphy (BS), while subsequent scintigraphy also showed an increased uptake in 80 (50%, progression). Multiple regression analysis revealed that stable or decreased ALP was an independent predictor for FP (p < 0.0001). ALP was an independent predictor for FP on subgroup analysis for breast and prostate cancer (p = 0.001 and p = 0.0223, respectively). Results of the study suggest that ALP is a useful serologic marker to differentiate FP from disease progression on bone scintigraphy in patients with bone metastasis. Clinical interpretation for scintigraphic aggravation can be further improved by the ALP data and it may prevent fruitless changes of therapeutic modality by misdiagnosis of disease progression in cases of FP.

【 授权许可】

Unknown