PERSONALIZED APPROACH TO PALLIATIVE RADIOTHERAPY: THE ROLE OF GENETIC MARKERS IN PATIENTS WITH BONE METASTASES

Dankov Maxim Valerievich, Provolukin Vladimir Evgenievich

Goal. To determine the role of genetic markers in predicting the effectiveness of palliative radiotherapy in patients with bone metastases. Materials and methods. A prospective randomized trial conducted at the Republican Cancer Center in Makhachkala (September 2023 – February 2025) included 26 patients with symptomatic bone metastases. All patients underwent a single palliative radiotherapy at a dose of 8 Gy; pain syndrome was assessed according to the BPI scale, and new generation sequencing (Oncomine Focus) was used for genetic analysis. Statistical processing included the χ2-test, the Cochran–Mantel–Hensel method, and multivariate modeling using LASSO. Results. A complete or partial response to therapy was noted in 34.6% of patients, while 37 variants were identified that were statistically significantly associated with radiosensitivity. The variants of the TNFRSF11B, XRCC2, and CDH11 genes made the greatest contribution to the prognosis, which is consistent with the pathogenetic mechanisms of DNA repair and bone remodeling. Conclusions. Genetic markers can serve as a reliable tool for patient stratification and individualization of palliative radiotherapy, which opens up prospects for a personalized approach in oncology. The results indicate the need to include molecular genetic profiling in clinical decision-making algorithms. The introduction of such approaches will optimize the choice of therapy, increase the effectiveness of treatment and reduce the risk of complications. Our data can serve as a basis for the development of national recommendations on the integration of genetic markers into the practice of palliative radiotherapy.

Keywords:palliative radiotherapy, bone metastases, genetic markers, personalized approach, treatment prognosis.