Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer
PURPOSE: Adjuvant chemotherapy has been associated with loss of bone mineral density (BMD) either as a direct effect or due to glucocorticoids used as supportive care medication. A prospective cohort study was conducted to evaluate changes in BMD from baseline to right after completion of chemothera...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993804/ https://www.ncbi.nlm.nih.gov/pubmed/27146497 http://dx.doi.org/10.1007/s00520-016-3250-y |
_version_ | 1782449196282937344 |
---|---|
author | Christensen, Carina Ørts Cronin-Fenton, Deirdre Frøslev, Trine Hermann, Anne Pernille Ewertz, Marianne |
author_facet | Christensen, Carina Ørts Cronin-Fenton, Deirdre Frøslev, Trine Hermann, Anne Pernille Ewertz, Marianne |
author_sort | Christensen, Carina Ørts |
collection | PubMed |
description | PURPOSE: Adjuvant chemotherapy has been associated with loss of bone mineral density (BMD) either as a direct effect or due to glucocorticoids used as supportive care medication. A prospective cohort study was conducted to evaluate changes in BMD from baseline to right after completion of chemotherapy, i.e., 4 months. METHODS: Dual-imaging X-ray absorptiometry (DXA) was performed at baseline and after completing anthracycline- and taxane-based chemotherapy to measure BMD in the spine, hip, and forearm in early-stage breast cancer patients. High-dose prednisolone was used at three weekly intervals to reduce nausea and vomiting. Patients were advised a daily calcium/vitamin D supplement. Linear regression was used to assess mean percentage change in BMD and 95 % confidence intervals (95 % CI) according to doses of prednisolone, menopausal status, smoking, and BMI. RESULTS: Eight patients were excluded: seven because of initiation of bisphosphonate treatment due to osteoporosis at baseline, and one had non-interpretable DXA. The final cohort included 97 patients with a mean age of 53 years (range 34–72). Mean cumulative prednisolone dose was 1308 mg (95 % CI 1255; 1362). BMD increased 1.36 % (95 % CI 0.7; 2.0, p < 0.001) in the spine and 1.27 % (95 % CI 0.9; 1.7, p < 0.001) in the hip. Forearm BMD did not change. Postmenopausal women had increases in spine BMD of 2.35 % (95 % CI 1.1; 3.6, p < 0.001) compared to premenopausal women. The spine BMD of current smokers decreased 1.67 % (95 % CI −3.3; −0.1, p = 0.04) compared to never/former smokers. CONCLUSIONS: Adjuvant chemotherapy supplemented with prednisolone was not associated with loss of BMD. Postmenopausal women gained bone mass, whereas current smokers lost bone mass. |
format | Online Article Text |
id | pubmed-4993804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-49938042016-09-07 Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer Christensen, Carina Ørts Cronin-Fenton, Deirdre Frøslev, Trine Hermann, Anne Pernille Ewertz, Marianne Support Care Cancer Original Article PURPOSE: Adjuvant chemotherapy has been associated with loss of bone mineral density (BMD) either as a direct effect or due to glucocorticoids used as supportive care medication. A prospective cohort study was conducted to evaluate changes in BMD from baseline to right after completion of chemotherapy, i.e., 4 months. METHODS: Dual-imaging X-ray absorptiometry (DXA) was performed at baseline and after completing anthracycline- and taxane-based chemotherapy to measure BMD in the spine, hip, and forearm in early-stage breast cancer patients. High-dose prednisolone was used at three weekly intervals to reduce nausea and vomiting. Patients were advised a daily calcium/vitamin D supplement. Linear regression was used to assess mean percentage change in BMD and 95 % confidence intervals (95 % CI) according to doses of prednisolone, menopausal status, smoking, and BMI. RESULTS: Eight patients were excluded: seven because of initiation of bisphosphonate treatment due to osteoporosis at baseline, and one had non-interpretable DXA. The final cohort included 97 patients with a mean age of 53 years (range 34–72). Mean cumulative prednisolone dose was 1308 mg (95 % CI 1255; 1362). BMD increased 1.36 % (95 % CI 0.7; 2.0, p < 0.001) in the spine and 1.27 % (95 % CI 0.9; 1.7, p < 0.001) in the hip. Forearm BMD did not change. Postmenopausal women had increases in spine BMD of 2.35 % (95 % CI 1.1; 3.6, p < 0.001) compared to premenopausal women. The spine BMD of current smokers decreased 1.67 % (95 % CI −3.3; −0.1, p = 0.04) compared to never/former smokers. CONCLUSIONS: Adjuvant chemotherapy supplemented with prednisolone was not associated with loss of BMD. Postmenopausal women gained bone mass, whereas current smokers lost bone mass. Springer Berlin Heidelberg 2016-05-05 2016 /pmc/articles/PMC4993804/ /pubmed/27146497 http://dx.doi.org/10.1007/s00520-016-3250-y Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Christensen, Carina Ørts Cronin-Fenton, Deirdre Frøslev, Trine Hermann, Anne Pernille Ewertz, Marianne Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
title | Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
title_full | Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
title_fullStr | Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
title_full_unstemmed | Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
title_short | Change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
title_sort | change in bone mineral density during adjuvant chemotherapy for early-stage breast cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993804/ https://www.ncbi.nlm.nih.gov/pubmed/27146497 http://dx.doi.org/10.1007/s00520-016-3250-y |
work_keys_str_mv | AT christensencarinaørts changeinbonemineraldensityduringadjuvantchemotherapyforearlystagebreastcancer AT croninfentondeirdre changeinbonemineraldensityduringadjuvantchemotherapyforearlystagebreastcancer AT frøslevtrine changeinbonemineraldensityduringadjuvantchemotherapyforearlystagebreastcancer AT hermannannepernille changeinbonemineraldensityduringadjuvantchemotherapyforearlystagebreastcancer AT ewertzmarianne changeinbonemineraldensityduringadjuvantchemotherapyforearlystagebreastcancer |