The effect of denosumab combined with radiotherapy on bone metabolic markers and prognosis in patients with bone metastases from non-small cell lung cancer
MA Changbo
MA Yingji
HAO Furong
Abstract：Objective This study aims to evaluate the efficacy of denosumab combined with intensity-modulated radiotherapy(IMRT)in patients with bone metastases from non-small cell lung cancer(NSCLC).Methods This randomized controlled trial included One hundred and twenty six NSCLC patients with bone metastases who were treated at the Qiaozhou Hospital of Tongji University Affiliated East Hospital fromMarch 2022 to December 2022.Patients were randomly divided into the study group(Sixty three cases,receiving denosumab combined with IMRT)and the control group(Sixty three cases,receiving only IMRT).Bone pain relief,bone metabolism markers(bone-specific alkaline phosphatase[BALP],C-terminal telopeptide of type Ⅰ collagen[β-CTX],N-terminal propeptide of type Ⅰ collagen[PINP]),health status(Karnofsky Performance Status[KPS]score),quality of life(FACT-L score),and the occurrence of skeletal-related events(SREs)were assessed before and after treatment.A 2-year follow-up was conducted,and overall survival(OS)and progression-free survival(PFS)were evaluated using the Kaplan-Meier method.Results After treatment,the research group demonstrated superior bone pain relief compared to the control group,with a statistically significant difference(P＜0.05).Both groups showed decreased levels of ALP and PTH,increased 25(OH)D levels,and improved KPS and FACT-L scores,with the research group outperforming the control group,indicating statistically significant differences(P＜0.05).The incidence of skeletal-related events(SREs)in the research group was 30.16％,significantly lower than the 50.79％observed in the control group(P＜0.05).After a 2-year follow-up,the median OS in the study group was 19.47±2.15 months,and the median PFS was 10.15±1.74 months,both significantly better than the control group(OS:16.92±2.03 months,PFS:8.07±1.46 months)(P＜0.05).Conclusions Denosumab combined with intensity-modulated radiotherapy significantly improves clinical outcomes in NSCLC patients with bone metastases.This combination therapy effectively alleviates bone pain,improves bone metabolism,reduces the occurrence of skeletal-related events,enhances quality of life,and significantly prolongs overall survival and progression-free survival.
Keywords：Non-small cell lung cancerBone metastasesDenosumabIntensity-modulated radiotherapyBone metabolism markersBone pain reliefQuality of lifePrognosis
Publication Date：2025-10-20
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：6( 480-484,492 )