Previous data indicate that one cycle of treatment with radium-223 (223Ra) did not significantly impair lymphocyte function in patients with metastasized, castration-resistant prostate cancer. The aim of the current study was to assess in 21 patients whether six cycles of this therapy had an effect on lymphocyte proliferation and interferon-γ and interleukin (IL)-10 ELISpot results. Lymphocyte proliferation after stimulation with microbial antigens and the production of interferon-γ continuously decreased after six cycles of radionuclide therapy, reaching statistical significance (p< 0.05) at months 1, 2, 4, and/or 6 after therapy. One month after the last cycle of therapy, 67% of patients showed a decrease in tumor burden. The tumor burden correlated negatively with IL-10 secretion at baseline, e.g., after stimulation with tetanus antigen (p< 0.0001,r= −0.82). As determined by receiver operating characteristic (ROC) curve analysis, tetanus-specific IL-10 spots at baseline had the highest predictive value (p= 0.005) for tumor burden at month 6, with an area under the curve (AUC) of 0.90 (sensitivity 100%, specificity 78%). In conclusion, we observed an additive effect of treatment with223Ra on immune function and found that IL-10 secretion at baseline predicted tumor burden at month 6 after treatment.
既往数据显示，单周期镭-223（223Ra）治疗对转移性去势抵抗性前列腺癌患者的淋巴细胞功能未产生显著损害。本研究旨在通过21例患者评估六个周期该疗法对淋巴细胞增殖及干扰素-γ、白细胞介素（IL）-10酶联免疫斑点实验结果的影响。经微生物抗原刺激后，淋巴细胞增殖能力与干扰素-γ产量在六个周期放射性核素治疗后持续下降，并在治疗后第1、2、4和/或6个月达到统计学显著性（p<0.05）。末次治疗周期后一个月，67%的患者肿瘤负荷降低。基线期肿瘤负荷与IL-10分泌呈负相关，例如破伤风抗原刺激后呈现显著负相关（p<0.0001，r=−0.82）。受试者工作特征（ROC）曲线分析显示，基线期破伤风特异性IL-10斑点数量对第6个月肿瘤负荷具有最高预测价值（p=0.005），曲线下面积（AUC）达0.90（灵敏度100%，特异度78%）。综上，我们观察到223Ra治疗对免疫功能存在累积效应，并发现基线期IL-10分泌水平可预测治疗后第6个月的肿瘤负荷。
肿瘤(癌症)患者之家