Biochemical markers of bone turnover in patients with spinal metastases after resistance training under radiotherapy – a randomized trial

BMC Cancer

Research Article

Heinz Jürgen Roth¹  Thomas Bruckner²  Michael Akbar³  Georg Omlor³  Jürgen Debus⁴  Harald Rief⁴  Robert Förster⁴  Tilman Bostel⁴  Ingmar Schlampp⁴  Stefan Rieken⁴  Thomas Welzel⁴ 

[1] Department of Endocrinology/Oncology, Limbach Laboratory Heidelberg, Im Breitspiel 15, 69126, Heidelberg, Germany;Department of Medical Biometry, University Hospital of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany;Department of Orthopaedics and Trauma Surgery, University Hospital of Heidelberg, Schlierbacherstrasse 120a, 69118, Heidelberg, Germany;Department of Radiation Oncology, University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany;

关键词: Bone metastases;    Spine;    Physical exercise;    Biochemical markers;    Resistance training;   

DOI  :  10.1186/s12885-016-2278-1

 received in 2014-12-09, accepted in 2016-03-13,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundTo compare the effects of resistance training versus passive physical therapy on bone turnover markers (BTM) in the metastatic bone during radiation therapy (RT) in patients with spinal bone metastases. Secondly, to evaluate an association of BTM to local response, skeletal-related events (SRE), and number of metastases.MethodsIn this randomized trial, 60 patients were allocated from September 2011 to March 2013 into one of the two arms: resistance training (Arm A) or passive physical therapy (Arm B) with thirty patients in each arm during RT. Biochemical markers such as pyridinoline (PYD), desoxy-pyridinoline (DPD), bone alkaline phosphatase (BAP), total amino-terminal propeptide of type I collagen (PINP), beta-isomer of carboxy-terminal telopeptide of type I collagen (CTX-I), and cross-linked N-telopeptide of type I collagen (NTX) were analyzed at baseline, and three months after RT.ResultsMean change values of PYD and CTX-I were significantly lower at 3 months after RT (p = 0.035 and p = 0.043) in Arm A. Importantly, all markers decreased in both arms, except of PYD and CTX-I in arm B, although significance was not reached for some biomarkers. In arm A, the local response was significantly higher (p = 0.003) and PINP could be identified as a predictor for survivors (OR 0.968, 95%CI 0.938–0.999, p = 0.043). BAP (OR 0.974, 95%CI 0.950–0.998, p = 0.034) and PINP (OR 1.025, 95%CI 1.001–1.049, p = 0.044) were related with an avoidance of SRE.ConclusionsIn this group of patients with spinal bone metastases, we were able to show that patients with guided resistance training of the paravertebral muscles can influence BTM. PYD and CTX-I decreased significantly in arm A. PINP can be considered as a complementary tool for prediction of local response, and PINP as well as BAP for avoidance of SRE.Trial registrationClinical trial identifier NCT 01409720. August 2, 2011.

【 授权许可】

CC BY   
© Rief et al. 2016