Changes in bone mineral density in men with prostate cancer during treatment with luteinizing hormone-releasing hormone (LHRH) agonist monotherapy.

摘要

Studies conducted on men with metastatic prostate cancer have shown that hypogonadism from orchiectomy and luteinizing hormone-releasing hormone (LHRH) agonist therapy resulted in significant decrease in bone mineral density (BMD). The purpose of this study is to compare changes in BMD levels in men who are receiving LHRH agonist monotherapy (LHRH group) than those who are on watchful waiting (WW group) for their non-metastatic prostate cancer over a six-month period.; A prospective, quasi-experimental design was used. Lumbar spine and proximal femur BMD studies were performed using dual energy x-ray absorptiomentry (DEXA) in 18 men on the LHRH group and 16 men on WW group at baseline and at 6 months. Demographic (age, ethnicity), health status (comorbidity, body mass index (BMI)), lifestyle (smoking, alcohol consumption, physical activity, dietary calcium) and disease variables (Gleason score, clinical stage, and PSA) were obtained. Univariate and multivariate analyses were used to identify relationships between demographic, health status, lifestyle, and disease variables and BMD in the spine and femur. T-test was used to compare percent change in BMD over 6-month period between the two groups.; At baseline, 73.5% had osteopenia (55.9%) or osteoporosis (17.6%) of the lumbar spine and/or femur. After 6 months, there was a statistically significant decline in BMD at the lumbar spine in the LHRH group as compared to the WW group (p ≤ 0.05). BMD decreased in the trochanter of the hip of the LHRH group, but did not reach statistical significance (p = 0.10). No significant differences in the incidence of osteopenia and osteoporosis between the two groups at baseline and at 6 months. Aging, low BMI, and elevated PSA were significantly correlated with bone loss in the spine and femur at baseline.; Based on the findings of our study, it may be a reasonable strategy to perform baseline and serial bone densitometry in men with prostate cancer, especially those over 70 years old and have slender stature. Early initiation of pharmacological agents and nursing interventions, such as the exercise and use of calcium and vitamin supplements, may be needed to prevent further progression of bone loss.