Impact of radiotherapy on bone health in women with rectal cancer- A prospective cohort study

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Rojvall, Annika SvanstromKarolinska Inst, Sweden; Capio S T Gorans Hosp, Sweden (author)

Impact of radiotherapy on bone health in women with rectal cancer- A prospective cohort study

Article/chapterEnglish2022

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ELSEVIER SCI LTD,2022
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LIBRIS-ID:oai:DiVA.org:liu-191231
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-191231URI
https://doi.org/10.1016/j.ejso.2022.06.028DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:151592350URI

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Language:English
Summary in:English

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Funding Agencies|Swedish Cancer Society; Stockholm Cancer Society; Bengt Ihre Research Fellowship; Bengt Ihre Foundation; Stockholm County Council; Karolinska Institutet; Region Ostergotland
Introduction: Pelvic radiotherapy (RT) increases the risk of pelvic insufficiency fractures. The aim was to investigate if RT is associated with changes in serum bone biomarkers in women with rectal cancer, and to examine the incidence of radiation-induced bone injuries and the association with bone biomarkers.Material and methods: Women diagnosed with rectal cancer stage I-III, planned for abdominal surgery +/- preoperative (chemo) RT, were prospectively included and followed one year. Serum bone biomarkers comprised sclerostin (regulatory of bone formation), CTX (resorption), BALP and PINP (for-mation). A subgroup was investigated with annual pelvic magnetic resonance imaging (MRI). The as-sociation between RT and bone biomarkers was explored in regression models.Results: Of 134 included women, 104 had surgery with preoperative RT. The formation markers BALP and PINP increased from baseline to one year in the RT-exposed group (p < 0.001, longitudinal comparison). In the adjusted regression analysis, the mean increase in PINP was higher in the RT-exposed than the unexposed group (17.6 (3.6-31.5) mg/L, p = 0.013). Sclerostin and CTX did not change within groups nor differed between groups. Radiation-induced injuries were detected in 16 (42%) of 38 women with available MRI. At one year, BALP was higher among women with than without bone injuries (p = 0.018, cross-sectional comparison).Conclusions: Preoperative RT was associated with an increase in the formation marker PINP, which could represent bone recovery following RT-induced injuries, commonly observed in participants evaluated with MRI. These findings should be further explored in larger prospective studies on bone health in rectal cancer patients.(c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
Rectal cancer treatment; Sclerostin; Carboxy-terminal cross-linking telopeptide; of type I collagen (CTX); Bone-specific alkaline phosphatase (BALP); Amino-terminal propeptide of type I; procollagen (PINP); Pelvicinsufficiency fractures

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Buchli, ChristianKarolinska Institutet (author)
Saaf, MariaKarolinska Inst, Sweden (author)
Magnusson, PerLinköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, Klinisk kemi(Swepub:liu)perma28 (author)
Radestad, Angelique FloterKarolinska Institutet (author)
Martling, AnnaKarolinska Institutet (author)
Segelman, JosefinKarolinska Institutet (author)
Karolinska InstitutetKarolinska Inst, Sweden; Capio S T Gorans Hosp, Sweden (creator_code:org_t)

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In:European Journal of Surgical Oncology: ELSEVIER SCI LTD48:12, s. 2509-25170748-79831532-2157

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