Téma: 

The loss of bone mass density of patients with prostate cancer treated with androgedeprivation therapy after 8-14 months

Stanislav Žiaran, Frederico M. Goncalves, Ján Breza

Introduction and objectives: Androgen deprivation therapy (ADT) for advanced prostate cancer is considered the standard therapy over the last half of century. Its use is associated with several adverse effects; one of the most important long-term side effects is the loss of bone mineral density (BMD) which may lead into skeletal complications. The aim of this study was to measure the loss BMD in period of 8-14 months, to asses the effect of ADT on bone metabolism, to detect and prevent skeletal complications during ADT. Patients and Methods: Bone mass density (BMD) of femoral neck and lumbar spine (L1-L4) were determined by dual-x-ray absorciometry (DXA) in 97 men with prostate cancer (mean age 73.4 years, SD ± 3.945) at the beginning of ADT, and then every 8-14 months (study group). Changes in BMD, pathologic fractures and possible demises were evaluated. Patients with osteoporosis were treated with the cooperation with osteologist. Measurements were also made on a control group of 89 patients (mean age 71.9 years, SD ± 3,687). Results: Patients with prostate cancer (study group) had significantly lower initial total BMD and BMD of lumbar spine (L1-L4) in comparison to the control group (p = 0.028, p = 0.022). Significant loss of total BMD, BMD of lumbar spine (L1-L4) after 8-14 months of ADT was detected in the study group (p < 0.001, p = 0.004) when compared to the control group. 4 patients from study group suffered pathologic vertebral fractures of L1-L4. Pathologic fractures were not detected in control group. Conclusions: Patients with prostate cancer have significantly lower initial total BMD and BMD of lumbar spine L1-L4. ADT leads into significant loss of total and lumbar L1-L4 BMD. The loss of BMD leads into skeletal complications and that is why BMD should be measured at the beginning of ADT and then periodically

Ročník 2010  Témy časopisu Clinical urology 1 / 2010

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