RESUMEN
The objective of this work was to determine the effect of androgen deprivation therapy (ADT) on rates of bone mineral density (BMD) loss in men with prostate cancer. It was a prospective study comparing men receiving ADT to age matched controls for 2 y. Subjects received a history, physical exam, bone mineral density measurement, and laboratory evaluation every 6 months. Thirty-nine subjects receiving continuous ADT for prostate cancer (subjects) were compared to 39 age-matched controls not receiving ADT (controls). Twenty-three subjects and 30 controls completed the study through 24 months. Men in the ADT group demonstrated greater rates of bone mineral density loss than men in the control group at every site except the lumbar spine. Twenty-four month per cent of bone mineral density loss is presented as mean+/-standard error (s.e.). At the distal forearm, the ADT group value was -9.4%+/-1.0% and -4.4%+/-0.3% for controls (P<0.0005). The ADT group femoral neck values were -1.9%+/-0.7% and 0.6%+/-0.5% in the control group (P=0.0016). The ADT group total hip value was -1.5%+/-1.0% and 0.8%+/-0.5% in the control group (P=0.0018). The ADT group trochanter value was -2.0%+/-1.3% and -0.1%+/-0.5% in the control group (P=0.0019). The ADT group lumbar spine value was -0.2%+/-0.8 % and 1.1%+/-0.6% in the control group (P=0.079). Our data demonstrate greater rates of bone mineral density loss in men receiving androgen deprivation therapy for prostate cancer.
Asunto(s)
Adenocarcinoma/complicaciones , Antagonistas de Andrógenos/efectos adversos , Andrógenos/deficiencia , Anilidas/efectos adversos , Antineoplásicos Hormonales/efectos adversos , Flutamida/efectos adversos , Hormona Liberadora de Gonadotropina/análogos & derivados , Goserelina/efectos adversos , Leuprolida/efectos adversos , Neoplasias Hormono-Dependientes/complicaciones , Orquiectomía/efectos adversos , Osteoporosis/inducido químicamente , Neoplasias de la Próstata/complicaciones , Absorciometría de Fotón , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/terapia , Anciano , Aminoácidos/orina , Antagonistas de Andrógenos/farmacología , Antagonistas de Andrógenos/uso terapéutico , Andrógenos/fisiología , Anilidas/farmacología , Anilidas/uso terapéutico , Antineoplásicos Hormonales/farmacología , Antineoplásicos Hormonales/uso terapéutico , Biomarcadores , Densidad Ósea/efectos de los fármacos , Remodelación Ósea/efectos de los fármacos , Calcio/orina , Quimioterapia Combinada , Flutamida/farmacología , Flutamida/uso terapéutico , Goserelina/farmacología , Goserelina/uso terapéutico , Humanos , Leuprolida/farmacología , Leuprolida/uso terapéutico , Masculino , Neoplasias Hormono-Dependientes/tratamiento farmacológico , Nitrilos , Osteoporosis/orina , Estudios Prospectivos , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/terapia , Testosterona/sangre , Compuestos de TosiloRESUMEN
Serum thyroglobulin measurement has greatly facilitated the clinical management of patients with differentiated thyroid cancer and a variety of other thyroid disorders. Thyroglobulin autoantibodies remain a significant obstacle to the clinical use of thyroglobulin measurement. The interpretation of any given thyroglobulin value requires the careful synthesis of all pertinent clinical and laboratory data available to the clinician. The diagnostic use of rhTSH-stimulated thyroglobulin levels has greatly facilitated the follow-up of low-risk patients with thyroid cancer. Although the measurement of thyroglobulin mRNA from peripheral blood is likely to affect the future management of these patients, it is expected that serum thyroglobulin measurement will continue to have a principal role in the care of patients with differentiated thyroid cancer.