Effects of Medical Treatment of Prostate Cancer on Bone Health

被引:33
作者
Formenti, Anna Maria [1 ]
Dalla Volta, Alberto [2 ]
di Filippo, Luigi [1 ]
Berruti, Alfredo [2 ]
Giustina, Andrea [1 ]
机构
[1] San Raffaele Vita Salute Univ, San Raffaele Hosp, Inst Endocrine & Metab Sci, Ist Ricovero & Cura Carattere Sci IRCCS, Milan, Italy
[2] Univ Brescia, Dept Med & Surg Specialties Radiol Sci & Publ Hlt, Med Oncol, Radiol Sci,Azienda Socio Sanit Terr ASST Spedali, Brescia, Italy
关键词
ANDROGEN-DEPRIVATION THERAPY; GROWTH-HORMONE-SECRETION; GLUCOCORTICOID-INDUCED OSTEOPOROSIS; RANDOMIZED CONTROLLED-TRIAL; LEAN BODY-MASS; MINERAL DENSITY; VERTEBRAL FRACTURES; TRABECULAR BONE; ZOLEDRONIC ACID; DOUBLE-BLIND;
D O I
10.1016/j.tem.2020.12.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Medical treatment of prostate cancer (PC) is multidisciplinary, resulting in prolonged survival. Androgen-deprivation therapy (ADT) can have negative effects on skeletal metabolism, particularly if combined with glucocorticoids. We discuss the pathophysiology and effects of ADT and glucocorticoids on skeletal endpoints, as well as the awareness and management of bone fragility. Coadministration of glucocorticoids is necessary with abiraterone because this causes a novel acquired form of 17-hydroxylase deficiency and synergistically increases the risk of fracture by affecting bone quality. Bone antiresorptive agents [selective estrogen receptor modulators (SERMS), bisphosphonates, and denosumab] increase bone mineral density (BMD) and in some instances reduce fracture risk in PC patients on ADT. Awareness and management of bone health in PC can be improved by integrating endocrinologists into the multidisciplinary PC team.
引用
收藏
页码:135 / 158
页数:24
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