Fujii Memorial Institute of Medical Sciences, Tokushima University, Tokushima, Japan.
Soen Orthopaedics, Osteoporosis and Rheumatology Clinic, Kobe, Japan.
J Bone Miner Metab. 2020 Mar;38(2):141-144. doi: 10.1007/s00774-020-01087-0. Epub 2020 Feb 4.
Androgen deprivation therapy and aromatase inhibitors are known to cause a decrease in bone mineral density and an increase in fractures. Patients receiving these treatments have been shown to have a fracture risk equal to or greater than that of patients with osteoporosis with prevalent fractures. This manual was created to prevent fractures in patients with cancer treatment-induced bone loss with high fracture risks who cannot be treated under the current Japanese guideline for the prevention and treatment of osteoporosis. This manual recommends drug treatment for patients with BMD - 2.0 ≤ T score < - 1.5 with the family history of hip fracture or 15% or more 10-year probability of major osteoporotic fractures by FRAX; or in patients with BMD T score < - 2.0. It is important to verify whether the use of this manual can reduce fractures and improve the quality of life of patients with cancer treatment-induced bone loss by prospective studies.
雄激素剥夺疗法和芳香化酶抑制剂已知可导致骨密度降低和骨折增加。接受这些治疗的患者的骨折风险与已发生骨折的骨质疏松症患者相等或更高。本手册旨在预防那些因癌症治疗导致骨质流失且骨折风险较高,而无法按照现行日本骨质疏松症预防和治疗指南进行治疗的患者发生骨折。本手册建议对 BMD 为-2.0≤T 评分<-1.5 且有髋部骨折家族史或 FRAX 预测的 10 年主要骨质疏松性骨折概率为 15%或更高的患者,或 BMD T 评分<-2.0 的患者进行药物治疗。通过前瞻性研究验证本手册的使用是否可以降低骨折风险并提高癌症治疗导致骨质流失患者的生活质量非常重要。