Yonehara Yukie, Iwamoto Ichiro, Kosha Shoichiro, Rai Yoshiaki, Sagara Yoshiatsu, Douchi Tsutomu
Department of Obstetrics and Gynecology, Kagoshima University Medical and Dental Hospital, Sakuragaoka, Kagoshima, Japan.
J Obstet Gynaecol Res. 2007 Oct;33(5):696-9. doi: 10.1111/j.1447-0756.2007.00634.x.
To investigate aromatase inhibitor-induced bone mineral loss and its prevention by bisphosphonate administration in postmenopausal breast cancer patients.
Subjects were 17 postmenopausal breast cancer patients (mean age, 63.3 +/- 9.9 years) receiving non-steroidal aromatase inhibitor (AI; anastrozole, 1 mg daily) only and 10 such patients (mean age, 65.0 +/- 5.1 years) receiving AI + bisphosphonate (risedronate sodium, 2.5 mg daily) for 6 months. All of the subjects had undergone surgical resection and had positive estrogen receptor tumor status. Age, age at menopause, years since menopause, height, weight, and body mass index (Wt/Ht(2)) were recorded. Lumbar spine (L2-4) bone mineral density (BMD), T-, and Z-scores were assessed on dual-energy X-ray absorptiometry before and after therapy.
In the AI-only group BMD, T-, and Z-scores significantly decreased from the baseline during the 6-month therapy period (P < 0.05). Mean decreases in L2-4 BMD and Z-score were 2.5% and 3.0%, respectively. In the AI + bisphosphonate group, however, BMD, T-, and Z-scores significantly increased from the baseline values (P < 0.01). Mean increases in L2-4 BMD and Z-score were 4.5% and 3.3%, respectively.
AI carries a potential risk of bone mineral loss despite the short therapy duration. Bisphosphonate has a preventive effect on this loss.
研究芳香化酶抑制剂引起的绝经后乳腺癌患者骨矿物质流失情况以及双膦酸盐给药对其的预防作用。
研究对象为17例仅接受非甾体芳香化酶抑制剂（AI；阿那曲唑，每日1毫克）的绝经后乳腺癌患者（平均年龄63.3±9.9岁）和10例接受AI+双膦酸盐（利塞膦酸钠，每日2.5毫克）治疗6个月的此类患者（平均年龄65.0±5.1岁）。所有受试者均接受了手术切除，且雌激素受体肿瘤状态为阳性。记录年龄、绝经年龄、绝经年限、身高、体重和体重指数（体重/身高²）。在治疗前后通过双能X线吸收法评估腰椎（L2-4）骨密度（BMD）、T值和Z值。
在仅接受AI治疗的组中，BMD、T值和Z值在6个月的治疗期内较基线水平显著下降（P<0.05）。L2-4 BMD和Z值的平均下降分别为2.5%和3.0%。然而，在AI+双膦酸盐组中，BMD、T值和Z值较基线值显著增加（P<0.01）。L2-4 BMD和Z值的平均增加分别为4.5%和3.3%。
尽管治疗时间较短，AI仍有导致骨矿物质流失的潜在风险。双膦酸盐对此种流失具有预防作用。
