Serum levels of bone turnover markers parallel the results of bone scintigraphy in monitoring bone activity of prostate cancer.

Objectives: To investigate the usefulness of bone turnover markers as a modality for monitoring bone metastasis in patients with prostate cancer with bone metastasis.

Methods: Serial measurements of pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), carboxyterminal pro-peptide of type I procollagen (PICP), prostate-specific antigen (PSA), and the percentage of the positive area on the bone scan were prospectively performed before and after hormonal therapy in 84 patients with prostate cancer with bone metastasis for median follow-up of 29 months.

Results: Serial ICTP and PICP levels in 48 patients without progression of bone metastasis demonstrated a downward trend during treatment and were almost within the normal range by the end of follow-up. The remaining 36 patients, who had PSA failure with progression of bone metastasis, showed an upward trend for serial ICTP and PICP levels before the progression of bone metastasis. The rates of detecting bone progression using bone turnover markers were higher than those using PSA levels on the basis of the percentage of clinical effectiveness and receiver operating characteristic curves.

Conclusions: Serial measurement of bone turnover markers is useful for monitoring the bone activity of prostate cancer and might detect early progression of bone metastasis in patients with PSA failure.