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Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis.
Velentza, Lilly; Filis, Panagiotis; Wilhelmsson, Mari; Kogner, Per; Herold, Nikolas; Sävendahl, Lars.
Afiliación
  • Velentza L; Division of Pediatric Endocrinology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
  • Filis P; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
  • Wilhelmsson M; Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
  • Kogner P; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
  • Herold N; Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
  • Sävendahl L; Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
Pediatrics ; 154(2)2024 Aug 01.
Article en En | MEDLINE | ID: mdl-39076127
ABSTRACT
CONTEXT There is an increasing population of childhood cancer survivors (CCS) at risk for treatment-related toxicities, including skeletal morbidities. Bone mineral density (BMD) is a proxy for bone health and reductions are associated with osteoporosis and fractures.

OBJECTIVE:

To investigate bone health in CCS by conducting a systematic review and meta-analysis of BMD after completed treatments. DATA SOURCES We searched Medline, Embase, Cochrane, and Web of Science in May 2019 and updated in May 2023. STUDY SELECTION Studies reporting BMD Z-scores measured with dual-energy x-ray absorptiometry in CCS after treatment completion. DATA EXTRACTION We performed a pooled analysis of studies reporting BMD Z-scores and thereafter we analyzed studies comparing BMD in survivors and healthy controls. All analyses were performed based on the site of BMD measurement.

RESULTS:

Of 4243 studies, 84 were included (N = 8106). The mean time off-treatment across the studies ranged from 2 months to 24 years. The overall pooled mean Z-score was -0.57 (95% confidence interval [CI] -0.59 to -0.55) in the whole-body, -0.84 (95% CI -0.86 to -0.83) in the lumbar spine, -0.79 (95% CI -0.81 to -0.77) in the femoral neck and -0.14 (95% CI -0.18 to -0.11) in the total hip. When comparing survivors with controls, BMD was significantly lower in survivors at all sites.

LIMITATIONS:

English publications, study-level meta-analysis.

CONCLUSIONS:

We showed a significant reduction of BMD Z-scores in CCS. Given the increased fracture risk already within -1 SD, these results emphasize the need for BMD surveillance and secondary prevention in CCS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Densidad Ósea / Supervivientes de Cáncer / Neoplasias Límite: Adolescent / Child / Humans Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Densidad Ósea / Supervivientes de Cáncer / Neoplasias Límite: Adolescent / Child / Humans Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos