Maintaining Bone Density in Patients Undergoing Treatment for Breast Cancer: Is There an Adjuvant Benefit?

被引:9
作者
Gnant, Michael [1 ]
Dubsky, Peter [1 ]
Fitzal, Florian [1 ]
Blaha, Peter [1 ]
Schoppmann, Sebastian [1 ]
Steger, Guenther [2 ]
Marth, Christian [3 ]
Samonigg, Hellmut [4 ]
Huettner, Katharina [5 ]
Fohler, Hannes [5 ]
Ruecklinger, Ernst [5 ]
Jakesz, Raimund [1 ]
Greil, Richard [6 ]
机构
[1] Med Univ Vienna, Dept Surg, A-1090 Vienna, Austria
[2] Med Univ Vienna, Dept Internal Med 1, Vienna, Austria
[3] Med Univ Innsbruck, Innsbruck, Austria
[4] Med Univ Graz, Graz, Austria
[5] Austrian Breast & Colorectal Canc Study Grp, Vienna, Austria
[6] Paracelsus Med Univ Salzburg, Salzburg, Austria
关键词
Bone loss; Bisphosphonates; Clodronate; Disease recurrence; Endocrine therapy; Risedronate; Zoledronic acid; PLUS ZOLEDRONIC ACID; 10-YEAR FOLLOW-UP; MINERAL DENSITY; PREMENOPAUSAL WOMEN; POSTMENOPAUSAL WOMEN; ENDOCRINE THERAPY; AROMATASE INHIBITOR; CLODRONATE TREATMENT; IMPROVED SURVIVAL; OVARIAN FAILURE;
D O I
10.3816/CBC.2009.s.002
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Women undergoing treatment for breast cancer often experience a marked decrease in bone mineral density. This decrease is observed with chemotherapy as well as endocrine therapy and is more pronounced and rapid than normal postmenopausal bone loss. Pharmacologic intervention is, therefore, necessary in many cases to preserve bone health and prevent fractures. Many small studies have demonstrated that cancer therapy-induced bone loss (CTIBL) is effectively prevented by bone-targeted therapies, such as bisphosphonates and other inhibitors of bone resorption. Recently, several trials have confirmed the efficacy of bisphosphonates in the prevention of CTIBL in both premenopausal and postmenopausal women with early-stage breast cancer. In addition, concomitant treatment with zoledronic acid 4 mg every 6 months and standard adjuvant endocrine therapy has been reported to significantly improve disease-free survival and decrease disease recurrence in bone as well as other sites compared with standard therapy alone. Zoledronic acid treatment has also decreased residual tumor volume in the neoadjuvant setting. Furthermore, long-term follow-up of a single study in patients with bone marrow micrometastases from breast cancer revealed overall survival benefits for patients receiving clodronate 1600 mg/day compared with placebo; however, combined results from several-trials of clodronate are inconclusive. Overall, a large body of evidence Is accumulating to support the potential adjuvant benefits of bisphosphonates in the treatment of early-stage breast cancer. Results from ongoing studies are expected to further elucidate the benefits of bisphosphonates in maintaining bone health and improving clinical outcomes in patients with breast cancer.
引用
收藏
页码:S18 / S27
页数:10
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