Abstract

The prevalance of bone metastasis from lung cancer was reported to range from 32% to 40%. Bone metastasis is usually diagnosed based on imaging studies. Biochemical bone metabolic markers also have been investigated in bone metastasis. In this study we investigated the clinical value of bone metabolic markers for detecting bone metastasis and response to therapy in lung cancer patients. Seventy patients with lung cancer were evaluated to determine the usefulness of bone metabolic markers. N telopeptide (NTx) and bone specific alkaline phosphotase (BAL) were evaluated in thirty three patients with and thirty six patients without bone metastasis. Pamidronate was also applied to sixteen lung cancer patients with bone metastasis. After four cycles of pamidronate therapy, we detected again these markers to evaluate the usefulness of these markers in monitoring of therapy. Serum concentration of NTx and BAL in patients without bone metastasis were significantly higher than in patients with bone metastasis. And also no significant difference was observed in serum concentrations of NTx and BAL between patients with local or multiple sides bone metastasis. But only significant correlation was seen in serum concentration of NTx before and after pamidronate treatment. After pamidronate treatment, NTx level significantly decreased in multiple sides bone matastasis patients. We decided that these results were related with our small and non-homogenous study groups and short therapy period. But this study is important to show that NTx is a useful marker in monitoring of bisphosphonate therapy in lung cancer patients with bone metastasis. In this study, the measurement of serum NTx level appeared to be the most useful marker in monitoring of therapy for bone metastasis from lung cancer.