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辅助化疗会改变乳腺癌女性的骨矿物质密度及相关血清生物标志物吗?

Does adjuvant chemotherapy change bone mineral density and related serum biomarkers in women with breast cancer?

作者信息

Safaei-Nodehi Reza, Esmaili Javad, Sharifian Ramazanali, Movaseghi Shafieh, Parkhideh Sayeh

机构信息

Hematology- Oncology and BMT center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Nuclear Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Caspian J Intern Med. 2017 Spring;8(2):91-98. doi: 10.22088/cjim.8.2.91.

Abstract

BACKGROUND

The primary objective of this study was to assess BMD change in Iranian females with breast cancer.

METHODS

A sample of 73 female breast cancer patients treated with adjuvant chemotherapy either alone or followed by radiotherapy between March 2013 and February 2016 were considered for this study. Bone mineral density (BMD) change was evaluated by measuring z-score of lumbar spine, femoral neck (right and left side) as well as biochemical measurements. With respect to WHO categorization for the treatment of osteoporosis, patients were categorized as normal BMD, osteopenic and all analysis was done separately.

RESULTS

In women with normal BMD, lumbar spine and femoral neck (right side) z-score decreased significantly by 15.7 and 39%, respectively (p<0.05). In osteoporosis group, there was no BMD change in any of the lumbar or femoral neck z-scores. However, in osteopenic patients, femoral neck BMD decreased significantly by 40.9% after 8 months (p=0.003). The level of all measured biomedical markers such as Ca, Alb, P and vitamin OHD decreased significantly in a follow-up visit in both osteoporosis and normal BMD.

CONCLUSION

Our results revealed that adjuvant chemotherapy led to unfavorable effects on lumbar spine and femoral neck means z-score during 8 months. Also, unfavorable changes in biochemical markers appeared in all groups.

摘要

背景

本研究的主要目的是评估伊朗乳腺癌女性的骨密度变化。

方法

本研究纳入了2013年3月至2016年2月期间接受辅助化疗(单独或化疗后放疗)的73例女性乳腺癌患者。通过测量腰椎、股骨颈(左右两侧)的z值以及生化指标来评估骨密度变化。根据世界卫生组织对骨质疏松症治疗的分类,将患者分为骨密度正常、骨量减少组,并分别进行所有分析。

结果

在骨密度正常的女性中,腰椎和股骨颈(右侧)的z值分别显著下降了15.7%和39%(p<0.05)。在骨质疏松组中,腰椎或股骨颈的任何z值均无骨密度变化。然而,在骨量减少的患者中,8个月后股骨颈骨密度显著下降了40.9%(p=0.003)。在随访中,骨质疏松组和骨密度正常组中所有测量的生物医学标志物如钙、白蛋白、磷和维生素OHD的水平均显著下降。

结论

我们的结果显示,辅助化疗在8个月期间对腰椎和股骨颈的平均z值产生了不利影响。此外,所有组的生化标志物均出现了不利变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9d3/5494042/41e2bc063ee5/cjim-8-091-g001.jpg

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