Bone Mineral Density Changes During Androgen Deprivation Therapy for Patients with Prostate Cancer

초록

Purpose: Androgen deprivation therapy (ADT) improves survival of patients with prostate cancer but leads to hypogonadal state. Gonadal hormones are essential for bone integrity and hypogonadism from ADT constitutes a major risk factor for osteoporosis. We investigated bone mineral density (BMD) changes according to duration of ADT and other clinical factors. Materials and Methods: A total of 102 patients with prostate cancer receiving ADT and 37 men of controls were evaluated. Dual energy x-ray absorptiometry was used to assess BMD at the lumbar spine. Age, body mass index (BMI), BMD, Gleason score, initial prostate-specific antigen (PSA), duration of ADT, smoking history, history of diabetes mellitus (DM), hypertension and preventive therapy of osteoporosis were obtained and analyzed. Results: BMD of prostate cancer patients with ADT was significantly lower than that of controls. Old age and low BMI were correlated with low BMD. Longer duration of ADT made more decrease in BMD of prostate cancer patients receiving ADT. Preventive therapy of osteoporosis during ADT showed significant correlation with high BMD and also decreased bone mass loss rate per year. Conclusions: Our study indicated that BMD was associated with ADT and its duration. Anti-osteoporotic therapy could decrease bone mass loss. Therefore we suggest that clinicians should be aware of impact of ADT on BMD to prevent osteoporosis.