Ockrim J L, Lalani E N, Banks L M, Svensson W E, Blomley M J, Patel S, Laniado M E, Carter S S, Abel P D
Department of Surgical Oncology and Technology, Imperial College and Hammersmith Hospitals NHS Trust, London, United Kingdom.
J Urol. 2004 Dec;172(6 Pt 1):2203-7. doi: 10.1097/01.ju.0000145511.56476.00.
Current androgen deprivation therapies for men with prostate cancer cause accelerated osteoporosis and a significant risk of osteoporotic fracture. We have recently shown that transdermal estradiol is an effective alternative for such patients. Here we report the impact of transdermal estradiol therapy on the bone mineral density of men with prostate cancer.
A total of 20 patients with newly diagnosed locally advanced or metastatic prostate cancer were treated with transdermal estradiol patches. Bone mineral density of the lumbar spine and the proximal femur was measured with dual-energy x-ray absorptiometry, and correlated with computerized tomography and isotope bone scan findings at 6-month intervals.
In all measured regions bone mineral density increased with time. By 1 year mean bone mineral density +/- SEM had increased by 3.60% +/- 1.6% in the lumbar spine (p = 0.055), 2.19% +/- 1.03% in the femoral neck (p = 0.055), 3.76% +/- 1.35% in the Ward's region (p = 0.008) and 1.90% +/- 0.85% in the total hip (p = 0.031), respectively. Of 12 osteoporotic sites 4 had improvement based on World Health Organization grading. All other sites improved toward a better classification.
Transdermal estradiol protects against bone loss in men with prostate cancer and may improve bone density in those at risk for osteoporotic fracture.
目前用于前列腺癌男性患者的雄激素剥夺疗法会加速骨质疏松，并显著增加骨质疏松性骨折的风险。我们最近表明，经皮雌二醇是这类患者的一种有效替代疗法。在此，我们报告经皮雌二醇治疗对前列腺癌男性患者骨密度的影响。
共有20例新诊断的局部晚期或转移性前列腺癌患者接受经皮雌二醇贴片治疗。采用双能X线吸收法测量腰椎和股骨近端的骨密度，并每6个月与计算机断层扫描和同位素骨扫描结果进行相关性分析。
在所有测量区域，骨密度均随时间增加。到1年时，腰椎的平均骨密度±标准误增加了3.60%±1.6%（p = 0.055），股骨颈增加了2.19%±1.03%（p = 0.055），沃德三角区增加了3.76%±1.35%（p = 0.008），全髋增加了1.90%±0.85%（p = 0.031）。根据世界卫生组织分级，12个骨质疏松部位中有4个有所改善。所有其他部位的分类也朝着更好的方向改善。
经皮雌二醇可预防前列腺癌男性患者的骨质流失，并可能提高有骨质疏松性骨折风险患者的骨密度。
