Hara Takuto, Nishimoto Hanako, Terakawa Tomoaki, Okamura Yasuyoshi, Suzuki Kotaro, Bando Yukari, Chiba Koji, Hyodo Yoji, Teishima Jun, Nakano Yuzo, Kuroda Ryosuke, Miyake Hideaki
Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Kobe, 650-0017, Japan.
J Bone Miner Metab. 2024 Nov;42(6):668-674. doi: 10.1007/s00774-024-01537-z. Epub 2024 Sep 12.
The trabecular bone score (TBS) has emerged as a convenient measure for assessing the microstructure of trabecular bone in the second through fourth lumbar vertebrae (L2-4) and can be conducted concurrently with bone mineral density (BMD) assessment. This study was performed to evaluate changes in BMD and the TBS during ADT for prostate cancer.
Consecutive patients who had prostate cancer without bone metastases at Kobe University Hospital were studied from March 2020 to December 2021. BMD and TBS were measured every 6 months from the start of treatment using Hologic Horizon devices (Hologic, Inc., Marlborough, MA, USA).
Thirty-four patients were followed for 2 years. Significant declines in BMD (-3.8% for femoral neck, -4.2% for total hip, and -6.1% for lumbar spine) and TBS (-16.6%) were noted after 2 years of ADT. Correlation analyses revealed a weak correlation between lumbar spine BMD and TBS at ADT initiation, but this correlation strengthened after 2 years. The multiple regression analysis results suggested that the rate of BMD loss may be slower in patients with a preserved pretreatment TBS.
In patients without bone metastases undergoing ADT for prostate cancer, notable decreases were found in both BMD and TBS over a 2-year treatment period. Factors influencing the TBS decline remain unclear; however, patients with a lower pretreatment TBS exhibited a more rapid decline in BMD.
小梁骨评分（TBS）已成为评估第二至第四腰椎（L2 - 4）小梁骨微观结构的一种便捷方法，并且可以与骨密度（BMD）评估同时进行。本研究旨在评估前列腺癌雄激素剥夺治疗（ADT）期间骨密度和小梁骨评分的变化。
对2020年3月至2021年12月在神户大学医院就诊的无骨转移的前列腺癌患者进行连续研究。从治疗开始每6个月使用Hologic Horizon设备（美国马萨诸塞州马尔伯勒市的Hologic公司）测量骨密度和小梁骨评分。
34例患者随访2年。雄激素剥夺治疗2年后，骨密度显著下降（股骨颈下降3.8%，全髋下降4.2%，腰椎下降6.1%），小梁骨评分下降16.6%。相关性分析显示，在开始雄激素剥夺治疗时，腰椎骨密度与小梁骨评分之间存在弱相关性，但2年后这种相关性增强。多元回归分析结果表明，治疗前小梁骨评分保留的患者骨密度丢失率可能较慢。
在接受雄激素剥夺治疗的无骨转移前列腺癌患者中，在2年的治疗期间骨密度和小梁骨评分均显著下降。影响小梁骨评分下降的因素尚不清楚；然而，治疗前小梁骨评分较低的患者骨密度下降更快。
