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...

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Autores principales: Christensen, Carina Ørts, Cronin-Fenton, Deirdre, Frøslev, Trine, Hermann, Anne Pernille, Ewertz, Marianne
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
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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.
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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
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