Lee Jeong Eun, Park Che Yon, Lee Eunhyun, Ji Yong Il
Department of Obstetrics and Gynecology, Inje University, Haeundae Paik Hospital, Busan, Korea.
Obstet Gynecol Sci. 2020 Jul;63(4):470-479. doi: 10.5468/ogs.20012. Epub 2020 Jul 8.
The purpose of this study was to evaluate the risk of osteopenia and osteoporosis by examining the bone mineral density (BMD) of the lumbar spine and femur in patients with gynecological cancer without bone metastasis and to evaluate the impact of treatment for different cancers on BMD.
This study retrospectively reviewed the medical records of 243 women with gynecological cancer and 240 controls between March 2010 and December 2016. Patients with cervical cancer (n=105), endometrial cancer (n=63), and ovarian cancer (n=75) were treated with total hysterectomy including bilateral salpingo-oophorectomy and/or chemotherapy and/or radiotherapy. For the control group, healthy post-menopausal women without gynecologic cancer were selected.
Before anticancer treatment, the BMD of patients with cervical cancer and ovarian cancer was significantly lower than that of the controls, and the BMD of patients with endometrial cancer was not significantly different from that of the controls. However, the BMD of endometrial cancer significantly decreased after treatment. According to the treatment methods, there were significant differences in the BMD of L3, L4, and the femur neck. Changes in the BMD were lowest in patients who underwent surgical treatment only, and the highest bone loss was found in patients who underwent postoperative concurrent chemoradiotherapy.
Patients with cervical and ovarian cancer had lower BMD than those in the control group before treatment, and patients with endometrial cancer had decreased bone density after treatment. Therefore, during the treatment of gynecological cancer, strategies should be implemented to mitigate these risks.
本研究旨在通过检测无骨转移的妇科癌症患者腰椎和股骨的骨密度（BMD）来评估骨质减少和骨质疏松的风险，并评估不同癌症治疗方法对骨密度的影响。
本研究回顾性分析了2010年3月至2016年12月期间243例妇科癌症女性患者和240例对照者的病历。宫颈癌患者（n = 105）、子宫内膜癌患者（n = 63）和卵巢癌患者（n = 75）接受了包括双侧输卵管卵巢切除术的全子宫切除术和/或化疗和/或放疗。对照组选取无妇科癌症的健康绝经后女性。
在抗癌治疗前，宫颈癌和卵巢癌患者的骨密度显著低于对照组，子宫内膜癌患者的骨密度与对照组无显著差异。然而，子宫内膜癌患者治疗后的骨密度显著下降。根据治疗方法，L3、L4和股骨颈的骨密度存在显著差异。仅接受手术治疗的患者骨密度变化最小，术后同步放化疗的患者骨丢失最多。
宫颈癌和卵巢癌患者治疗前的骨密度低于对照组，子宫内膜癌患者治疗后骨密度降低。因此，在妇科癌症治疗期间，应实施相应策略以降低这些风险。
