Takahashi Shunji
Cancer Chemotherapy Center and Cancer Institute Hospital, Japanese Foundation for Cancer Research, Japan.
Clin Calcium. 2011 Aug;21(8):1239-47.
Treatment for cancer may cause gonadal dysfunction and bone loss (cancer treatment-induced bone loss ; CTIBL) . Especially, endocrine therapies for breast cancer or prostate cancer carry a significant risk of CTIBL. Therapy-induced premature menopause in premenopausal breast cancer patients, aromatase inhibitor in postmenopausal breast cancer patients, and LHRH agonist with or without anti-androgen in prostate cancer patients may cause bone loss of 5% or more. RANKL (receptor activator of nuclear factor-κB ligand) antibody (denosumab) is effective for prevention of CTIBL and it may prevent CTIBL-induced fracture. During cancer treatment with gonadal dysfunction, bone mineral density should be carefully followed to avoid QOL impairment due to osoteoporosis.
癌症治疗可能会导致性腺功能障碍和骨质流失(癌症治疗引起的骨质流失;CTIBL)。特别是,乳腺癌或前列腺癌的内分泌治疗具有导致CTIBL的重大风险。绝经前乳腺癌患者的治疗导致的过早绝经、绝经后乳腺癌患者使用芳香化酶抑制剂以及前列腺癌患者使用促性腺激素释放激素(LHRH)激动剂(无论是否联用抗雄激素)都可能导致5%或更多的骨质流失。核因子κB受体活化因子配体(RANKL)抗体(地诺单抗)对预防CTIBL有效,并且可能预防CTIBL引起的骨折。在伴有性腺功能障碍的癌症治疗期间,应密切监测骨矿物质密度,以避免因骨质疏松导致生活质量受损。