• Ragnhild Habberstad, Nina Aass, Tom Eirik Mollnes, Jan Kristian Damås, Cinzia Brunelli, Romina Rossi, Elena Garcia-Alonso, Stein Kaasa, and Pål Klepstad.
• European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU (R.H., P.K.), Norwegian University of Science and Technology and St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway; Cancer Clinic, St. Olavs hospital (R.H.), Trondheim University Hospital, Trondheim, Norway. Electronic address: ragnhild.habberstad@gmail.com.
• J Pain Symptom Manage. 2022 Oct 1; 64 (4): 330-339.

ContextInflammation is proposed to influence tumor response in radiotherapy (RT). Clinical studies to investigate the relationship between inflammatory markers and RT response is warranted to understand the variable RT efficacy in patients with painful bone metastases.ObjectivesTo evaluate the association between inflammatory markers and analgesic response to RT in patients with painful bone metastases.MethodsAdult patients from 7 European study sites undergoing RT for painful bone metastases were included in this prospective and longitudinal analysis. The association between RT response and 17 inflammatory markers at baseline, as well as the association between RT response and the changes observed in inflammatory markers between baseline and three and eight weeks after RT, was analyzed with univariate regression analyses. Baseline analyses were adjusted for potential clinical predictors of RT response.ResultsNone of the inflammatory markers were significantly associated with an upcoming RT response in the analysis of 448 patients with complete baseline data. In patients available for follow-up, the three-week change in TNF (P 0.017), IL-8 (P 0.028), IP-10 (P 0.032), eotaxin (P 0.043), G-CSF (P 0.033) and MCP-1 (P 0.002) were positively associated with RT response, while the three-week change in CRP (P 0.006) was negatively associated.ConclusionResults from this study show an association between RT response and change in pro-inflammatory mediators and indicate that inflammation may be important to achieve an analgesic RT response in patients with painful bone metastases. None of the investigated inflammatory markers were found to be pre-treatment predictors of RT response.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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