Prevalence of Osteoporosis During Long-Term Androgen Deprivation Therapy in Patients with Prostate Cancer
Received 20 July 2006; accepted 16 November 2006.
Objectives
To know the prevalence of osteoporosis in patients with prostate cancer according to the duration of androgen deprivation therapy (ADT).
Methods
Dual energy x-ray absorptiometry was used to assess the bone mineral density (BMD) at the lumbar spine, femoral neck, Ward’s triangle, trochanter, and total hip in 390 patients free of bone metastases. Osteoporosis was diagnosed if a T-score of less than 2.5 was detected at any measurement site. A subset of 124 patients were hormone naive at BMD testing, and 112 had undergone ADT for 2 years, 61 for 4 years, 37 for 6 years, 35 for 8 years, and 21 for 10 years or longer.
Results
The osteoporosis rate was 35.4% in hormone-naive patients, 42.9% after 2 years of ADT, 49.2% after 4 years, 59.5% after 6 years, 65.7% after 8 years, and 80.6% after 10 or more years. Conversely, the rate of normal BMD decreased from 19.4% in hormone-naive patients to 17.8% after 2 years of ADT, 16.4% after 4 years, 10.8% after 6 years, 5.7% after 8 years, and 0% after 10 or more years of ADT.
Conclusions
The prevalence of osteoporosis seemed high in hormone-naive patients with prostate cancer, and it increased to more than 80% after 10 years of ADT. Because of the increased risk of bone fractures in those patients, clinicians should be aware of the impact of ADT on BMD to prevent bone mass loss.
aDepartment of Urology, Vall d’Hebron Hospital, Autónoma University School of Medicine, Barcelona, Spain
bDepartment of Nuclear Medicine, Vall d’Hebron Hospital, Autónoma University School of Medicine, Barcelona, Spain
cBasic Research Unit, Vall d’Hebron Hospital, Autónoma University School of Medicine, Barcelona, Spain
Reprint requests: Jacques Planas Morin, M.D., Department of Urology, Vall d’Hebron University Hospital, P. Vall d’Hebron 119-129, Barcelona 08035, Spain.
ABSTRACT