Palliative Radiotherapy in Cancer Patients with Increased Serum C-Reactive Protein Level

Abstract

Background/aim: Connections exist between inflammation and cancer, for example with regard to disease progression and prognosis. Therefore, we investigated whether systemic inflammatory processes indicated by increased serum C-reactive protein (CRP) provide prognostic information for physicians prescribing palliative radiotherapy.

Patients and methods: We analyzed data from 781 patients and evaluated prognostic factors for survival.

Results: Only 277 patients (35%) had CRP <8 mg/l before radiotherapy. No significant association was observed between CRP level and steroid treatment. In patients with the highest CRP level (>60 mg/l, 20% of patients), intravenous therapy with antibiotics was more common. CRP significantly influenced survival and contributed prognostic information together with established parameters, such as performance status (PS). In the multivariate model, white blood cell count did not provide relevant additional information. A simple four-tiered prognostic score solely based on CRP showed promising results.

Conclusion: Most patients treated with palliative radiotherapy had increased CRP. This widely available biomarker might improve decision-making and should be further validated.

Keywords: C-reactive protein; Palliative radiotherapy; antibiotics; inflammation; metastatic cancer; prognostic factors.