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利塞膦酸盐可恢复接受雄激素剥夺治疗的前列腺癌患者的骨质流失。

Risedronate recovers bone loss in patients with prostate cancer undergoing androgen-deprivation therapy.

作者信息

Izumi Kouji, Mizokami Atsushi, Sugimoto Kazuhiro, Narimoto Kazutaka, Miwa Sotaro, Maeda Yuji, Kadono Yoshifumi, Takashima Mitsuhiro, Koh Eitetsu, Namiki Mikio

机构信息

Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

出版信息

Urology. 2009 Jun;73(6):1342-6. doi: 10.1016/j.urology.2009.01.046. Epub 2009 Apr 15.

Abstract

OBJECTIVES

To perform a prospective observational study between risedronate and no risedronate (control) groups to determine the effectiveness of risedronate against bone loss in patients with prostate cancer (PCa) receiving androgen-deprivation therapy (ADT). ADT for PCa has iatrogenic complications (eg, bone loss and fracture).

METHODS

We enrolled 60 Japanese patients with PCa who were receiving ADT or were newly scheduled for ADT. The lumbar spine bone mineral density (BMD) was determined by dual-energy x-ray absorptiometry. Patients with a BMD <90% of the young adult mean received risedronate. We analyzed 29 and 27 patients in the risedronate and control groups, respectively. The BMD, urinary deoxypyridinoline, and serum bone alkaline phosphatase were measured as bone turnover markers at 6 and 12 months.

RESULTS

The BMD/young adult mean ratio correlated inversely with the duration of ADT. The initial mean BMD was significantly lower in the risedronate group than in the control group (1.02 +/- 0.19 vs 1.19 +/- 0.16 g/cm(2)). We focused on patients treated with ADT for >6 months. The mean percentage of changes in the BMD/young adult mean ratio of the risedronate and control groups was +2.6 +/- 4.5% and -2.8 +/- 2.6% after 1 year, respectively (P = .0001). The urinary deoxypyridinoline and bone alkaline phosphatase in the risedronate group decreased significantly after 12 months compared with the levels in the controls.

CONCLUSIONS

The results of our study have shown that oral administration of risedronate is effective for the recovery of ADT-induced bone loss in patients with PCa.

摘要

目的

进行一项前瞻性观察性研究,比较利塞膦酸盐组与非利塞膦酸盐(对照组),以确定利塞膦酸盐对接受雄激素剥夺治疗(ADT)的前列腺癌(PCa)患者骨质流失的疗效。PCa的ADT存在医源性并发症(如骨质流失和骨折)。

方法

我们纳入了60例正在接受ADT或新安排接受ADT的日本PCa患者。采用双能X线吸收法测定腰椎骨密度(BMD)。BMD低于年轻成人平均值90%的患者接受利塞膦酸盐治疗。我们分别分析了利塞膦酸盐组和对照组的29例和27例患者。在6个月和12个月时测量BMD、尿脱氧吡啶啉和血清骨碱性磷酸酶作为骨转换标志物。

结果

BMD/年轻成人平均值的比值与ADT持续时间呈负相关。利塞膦酸盐组的初始平均BMD显著低于对照组(1.02±0.19 vs 1.19±0.16 g/cm²)。我们重点关注接受ADT治疗超过6个月的患者。1年后,利塞膦酸盐组和对照组的BMD/年轻成人平均值比值的平均变化百分比分别为+2.6±4.5%和-2.8±2.6%(P = 0.0001)。与对照组相比,利塞膦酸盐组的尿脱氧吡啶啉和骨碱性磷酸酶在12个月后显著降低。

结论

我们的研究结果表明,口服利塞膦酸盐对PCa患者ADT诱导的骨质流失恢复有效。

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