Hellenic Society of Breast Surgeons, 6 Eslin Street, 11523, Athens, Greece.
J Cancer Res Clin Oncol. 2012 Sep;138(9):1569-77. doi: 10.1007/s00432-012-1233-z. Epub 2012 May 3.
We investigated whether age at anastrozole (A) initiation influences the effect of treatment on bone mineral density (BMD). We conducted a post hoc analysis of the dataset of Arimidex Bone Mass Index Oral Bisphosphonates prospective trial, studying the effect of risedronate (R) on BMD of postmenopausal, early breast cancer patients receiving A.
Patients were stratified into those with normal BMD or mild osteopenia (T > -2) receiving A-only and patients with mild or severe osteopenia (T ≤ -2) or osteoporosis (T < -2.5) receiving A and per os R (A + R). Depending on age on treatment initiation, patients were grouped into two age cohorts, above and below 65 years. BMD change in lumbar spine (LS) and hip (HP) was evaluated at 12 months. An analysis of patients with normal BMD at baseline was additionally performed.
Among patients receiving A-only, women ≤65 years were more likely to have a decrease in LS-BMD than older (p = 0.034). HP-BMD decrease at 12 months was not related to age (p = 0.182). In patients with mild or severe osteopenia or osteoporosis, treated with A + R, no age effect was observed for LS or HP (p = 0.099 and p = 0.939, respectively). Among patients with normal BMD at baseline, the age effect on LS-BMD change was more profound (p = 0.026).
Our study suggests that younger postmenopausal women with normal BMD or mild osteopenia receiving A-only face an increased risk of bone loss in LS. Among patients with mild or severe osteopenia or osteoporosis treated with A + R, 12 months LS or HP BMD variations were configured regardless of age group.
我们研究了阿那曲唑（A）起始年龄是否影响治疗对骨密度（BMD）的影响。我们对 Arimidex 骨密度指数口服双膦酸盐前瞻性试验数据集进行了事后分析，研究了利塞膦酸盐（R）对接受 A 治疗的绝经后早期乳腺癌患者 BMD 的影响。
患者根据基线时的 BMD 分为正常或轻度骨质减少（T>-2）仅接受 A 治疗组和轻度或严重骨质减少（T≤-2）或骨质疏松（T<-2.5）接受 A 和口服 R（A+R）治疗组。根据治疗起始时的年龄，患者分为 65 岁以上和 65 岁以下两个年龄组。在 12 个月时评估腰椎（LS）和髋部（HP）的 BMD 变化。还对基线时 BMD 正常的患者进行了分析。
在仅接受 A 治疗的患者中，≤65 岁的女性 LS-BMD 下降的可能性大于年龄较大的患者（p=0.034）。12 个月时 HP-BMD 下降与年龄无关（p=0.182）。在接受 A+R 治疗的轻度或严重骨质减少或骨质疏松患者中，LS 或 HP 无年龄影响（p=0.099 和 p=0.939）。在基线时 BMD 正常的患者中，LS-BMD 变化的年龄影响更为显著（p=0.026）。
我们的研究表明，接受 A 单药治疗的绝经后早期轻度骨质减少或正常 BMD 的年轻女性，LS 骨丢失风险增加。在接受 A+R 治疗的轻度或严重骨质减少或骨质疏松患者中，12 个月时 LS 或 HP 的 BMD 变化不受年龄组影响。
