Study on the Correlation between Pain and Cytokine Expression in the Peripheral Blood of Patients with Bone Metastasis of Malignant Cancer Treated Using External Radiation Therapy

Abstract

The incidence of cancer is increasing worldwide on a yearly basis, with the number of patients with bone metastases also increasing annually. Events associated with bone metastases can seriously affect patient quality of life, through pain, hypercalcemia, bone marrow regeneration disorders, and spinal cord compression. In this nonrandomized controlled clinical trial study, we focused on the relationship between bone metastasis, pain, and cytokines before and after radiotherapy. We hypothesized that radiotherapy alters the cytokine profile of the local bone environment. Combined with the analgesic effects of radiotherapy, certain cytokines may be very sensitive to radiation. External radiation therapy is commonly used to treat cancer patients with bone metastases and can effectively relieve metastasis-related pain, although its underlying mechanisms have not been fully elucidated. For this case-control study, we recruited 30 cancer patients with bone metastasis and 30 healthy individuals. Peripheral venous blood from healthy individuals was collected. The clinical characteristics and peripheral venous blood were collected from patients one week before and one week after radiotherapy. The preradiotherapy and postradiotherapy pain scores, quality of life (QOL), and blood cytokine profiles of the patients to that of the controls were collected to identify pain-related cytokines. Finally, the pain score and the quality of life score improved significantly after radiotherapy. Moreover, the preradiotherapy and postradiotherapy blood cytokine profiles of the patients showed significant differences, indicating that the analgesic effect of radiotherapy against bone metastases is mediated via altered cytokine production. Furthermore, some cytokines were more sensitive to radiotherapy. The levels of MIP-1δ, MCP-2, TIMP-1, RANTES, IGFBP3, and TNF-α showed significant differences in the pairwise comparative analysis and may therefore mediate pain associated with bone metastasis.