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Abstract：
Over the last years has emerged the urgent need for the identification of reliable prognostic biomarkers able to potentially identify metastatic castration-resistant prostate cancer (mCRPC) patients most likely to benefit from Radium-223 (Ra-223) since baseline. In the present monocentric retrospective study, we analyzed the prognostic power of systemic inflammation biomarkers and 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET)-derived parameters and their potential interplay in this clinical setting. The following baseline laboratory parameters were collected in 59 mCRPC patients treated with Ra-223: neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), and systemic inflammation index (SII), while maximum Standardized Uptake Value, Metabolic Tumor Volume (MTV), and Total Lesion Glycolysis (TLG) were calculated in the 48 of them submitted to baseline FDG-PET. At the univariate analysis, NLR, dNLR, MTV, and TLG were able to predict the overall survival (OS). However, only NLR and MTV were independent predictors of OS at the multivariate analysis. Additionally, the occurrence of both increased NLR and MTV at baseline identified mCRPC patients at higher risk for lower long-term survival after treatment with Ra-223. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden and their combination might represent potentially valuable tools for identifying mCRPC patients who are most likely to benefit from Ra-223. However, further studies are needed to reproduce these findings in larger settings.
摘要：
在过去的几年中，迫切需要鉴定可靠的预后生物标志物，这些生物标志物能够潜在地鉴定自基线以来最可能受益于镭-223（Ra-223）的转移性去势抵抗性前列腺癌（mCRPC）患者。在目前的单中心回顾性研究中，我们分析了全身性炎症生物标志物和18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG-PET)衍生参数的预后功效,以及它们在该临床环境中的潜在相互作用.在用Ra-223治疗的59名mCRPC患者中收集了以下基线实验室参数：中性粒细胞与淋巴细胞比率（NLR），派生NLR(dNLR)，淋巴细胞与单核细胞比率（LMR），血小板与淋巴细胞比率（PLR），和全身炎症指数（SII），而最大标准化摄取值，代谢肿瘤体积（MTV），在接受基线FDG-PET的48例中计算总损伤糖酵解（TLG）。在单变量分析中，NLR,dNLR,MTV,TLG能够预测总生存期(OS)。然而,在多变量分析中,只有NLR和MTV是OS的独立预测因子.此外,基线时NLR和MTV均增加的发生表明,接受Ra-223治疗后,mCRPC患者的长期生存率较低.总之,全身炎症的程度，代谢活跃肿瘤负荷的定量及其组合可能代表了用于鉴定最有可能从Ra-223获益的mCRPC患者的潜在有价值的工具.然而,需要进一步的研究来在更大的环境中重现这些发现.
