Special emphasis on bone health management in prostate cancer patients: a prospective longitudinal study
Int. braz. j. urol
; 46(3): 363-373, May-June 2020. tab, graf
Article
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| LILACS
| ID: biblio-1090615
Biblioteca responsable:
BR1.1
ABSTRACT
ABSTRACT Introduction:
Use of androgen deprivation therapy (ADT) in carcinoma prostate (CaP) has deleterious effect on bone mineral density (BMD) leading to increase incidence of osteoporosis and skeletal-related events. We evaluated bone health status and impact of bone-directed therapy (BDT) and ADT on BMD in these patients from Jan 2015-Dec 2018. Materials andMethod:
Baseline bone health was assessed using Tc-99 MDP Bone scan/ DEXA scan for patients on ADT. Monthly zoledronic acid (ZA) was given to high-risk candidates (T-score ≤2.5 or previous hip/vertebral fracture) or Skel et al. metastatic patients who were receiving ADT. Baseline and follow-up (at 12-months) BMD using DEXA scan at various sites (spine, femur total, femur neck and radius) and subjective improvement in bony pain using Numeric Pain Rating Score after administration of ZA were compared.Results:
A total of 96-patients of locally advanced and metastatic prostate cancer receiving ADT with or without BDT were included in the study cohort. Mean age of presentation was 68.4±15.61 years. Median serum PSA was 32.2±13.1ng/mL. There was significant improvement in mean BMD (T-score) in 64-patients post ZA therapy at 12-months (at femoral total, femoral neck and spine; 0.95, 0.79 and 0.68, respectively) (p <0.05) while there was significant deterioration in mean BMD at 12-months (at spine, femoral neck and femoral total; −0.77, −0.55 and −0.66, respectively) in 32 patients who did not receive ZA and were on ADT (p <0.05). Pain scores significantly decreased in patients after 12-months of ZA use (−2.92±2.16, p <0.01).Conclusion:
Bone-directed therapy (Zoledronic acid) leads to both subjective and objective improvement in bone health of prostate cancer patients on ADT.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Neoplasias de la Próstata
/
Densidad Ósea
/
Antagonistas de Andrógenos
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Aged
/
Aged80
/
Humans
/
Male
Idioma:
En
Revista:
Int. braz. j. urol
Asunto de la revista:
UROLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
India
Pais de publicación:
Brasil