1
|
Huang S, Wu L, Lin S, Cai S, Zhou J. Analysis of factors related to osteoporotic vertebral fracture in prostate cancer patients. Discov Oncol 2024; 15:34. [PMID: 38347321 PMCID: PMC10861407 DOI: 10.1007/s12672-024-00886-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/07/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE This study was aimed at exploring the osteoporotic vertebral fracture rate and the related causal factors in prostate cancer patients before and after treatment. METHODS One hundred prostate cancer patients were recruited in this study. One hundred men without prostate cancer history were selected as the control group. The study was approved by the Medical Ethics Committee under Ethics number B2021-373R and the requirement for the informed consent was waived. The T4-L1 vertebral body of the case group and the control group before and after treatment was evaluated according to Genant's semi-quantitative method. The difference in vertebral body fracture rate between the case group and the control group and the changes in vertebral body fracture rate before and after treatment among the case group were compared. They were grouped according to age, body mass index (BMI), prostate-specific antigen (PSA) levels, Gleason grade, and androgen deprivation therapy (ADT). Univariate and multivariate logistic regression models were used to determine the factors significantly associated with vertebral fracture rate in prostate cancer patients. RESULTS The prevalence of vertebral fracture was 16% and 31% in prostate cancer patients before and after treatment, respectively, and 29% in the control group. The vertebral fracture rate of the patients before treatment significantly differed that of the control group and the patients after treatment. Univariate analysis showed that age, PSA levels, and treatment parameters were the significant influencing factors of vertebral fracture rates. Multivariate logistic regression analysis showed that age was the main influencing factor of vertebral fracture rates. CONCLUSION Osteoporotic vertebral fractures in patients with prostate cancer was associated with many factors. And the incidence of vertebral fracture in prostate cancer patients after ADT was significantly higher than that before treatment.
Collapse
Affiliation(s)
- Shunfa Huang
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, No.668 Jinhu Road, Huli District, Xiamen, 361015, China
| | - Lilan Wu
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, No.668 Jinhu Road, Huli District, Xiamen, 361015, China
| | - Shuting Lin
- Department of Radiology, The Second Affiliated Hospital of Fujian Medical University, No.34 Zhongshan North Road, Licheng District, Quanzhou, 362000, China
| | - Siqing Cai
- Department of Radiology, The Second Affiliated Hospital of Fujian Medical University, No.34 Zhongshan North Road, Licheng District, Quanzhou, 362000, China.
| | - Jianjun Zhou
- Department of Radiology, Zhongshan Hospital (Xiamen), Fudan University, No.668 Jinhu Road, Huli District, Xiamen, 361015, China.
- Xiamen Municipal Clinical Research Center for Medical Imaging, No.668 Jinhu Road, Huli District, Xiamen, 361015, China.
| |
Collapse
|
2
|
Wu CC, Chen PY, Wang SW, Tsai MH, Wang YCL, Tai CL, Luo HL, Wang HJ, Chen CY. Risk of Fracture During Androgen Deprivation Therapy Among Patients With Prostate Cancer: A Systematic Review and Meta-Analysis of Cohort Studies. Front Pharmacol 2021; 12:652979. [PMID: 34421586 PMCID: PMC8378175 DOI: 10.3389/fphar.2021.652979] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Androgen deprivation therapy (ADT) suppresses the production of androgen, and ADT is broadly used for intermediate or higher risk disease including advanced and metastatic cancer. ADT is associated with numerous adverse effects derived from the pharmacological properties. Previous meta-analysis on fracture risk among ADT users possessed limited data without further subgroup analysis. Risk estimation of updated real-world evidence on ADT-related fracture remains unknown. Objectives: To assess the risk of fracture and fracture requiring hospitalization associated with ADT among prostate cancer population on different disease conditions, treatment regimen, dosage level, fracture sites. Methods: The Cochrane Library, PubMed, and Embase databases were systematically screened for eligible cohort studies published from inception to March 2020. Two authors independently reviewed all the included studies. The risks of any fracture and of fracture requiring hospitalization were assessed using a random-effects model, following by leave-one-out, stratified, and sensitivity analyses. The Grading of Recommendations Assessments, Development and Evaluations (GRADE) system was used to grade the certainty of evidence. Results: Sixteen eligible studies were included, and total population was 519,168 men. ADT use is associated with increasing fracture risk (OR, 1.39; 95% CI, 1.26-1.52) and fracture requiring hospitalization (OR, 1.55; 95% CI, 1.29-1.88). Stratified analysis revealed that high-dose ADT results in an elevated risk of fracture with little statistical heterogeneity, whereas sensitivity analysis restricted to adjust for additional factors indicated increased fracture risks for patients with unknown stage prostate cancer or with no restriction on age with minimal heterogeneity. The GRADE level of evidence was moderate for any fracture and low for fracture requiring hospitalization. Conclusion: Cumulative evidence supports the association of elevated fracture risk with ADT among patients with prostate cancer, including those with different disease conditions, treatment regimens, dose levels, and fracture sites. Further prospective trials with intact information on potential risk factors on fracture under ADT use are warranted to identify the risky population.
Collapse
Affiliation(s)
- Cheng Chih Wu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Po Yen Chen
- Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih Wei Wang
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng Hsuan Tsai
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu Chin Lily Wang
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ching Ling Tai
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hao Lun Luo
- Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hung-Jen Wang
- Division of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chung Yu Chen
- Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
4
|
May A, Henke J, Au D, Raza SJ, Davaro F, Hamilton Z, Siddiqui SA. National Trends in the Utilization of Androgen Deprivation Therapy for Very Low Risk Prostate Cancer. Urology 2019; 130:79-85. [DOI: 10.1016/j.urology.2019.02.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 10/26/2022]
|
5
|
Poulsen MH, Frost M, Abrahamsen B, Gerke O, Walter S, Lund L. Osteoporosis and prostate cancer; a 24-month prospective observational study during androgen deprivation therapy. Scand J Urol 2019; 53:34-39. [DOI: 10.1080/21681805.2019.1570328] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Mads Hvid Poulsen
- Department of Urology, Odense University Hospital, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
| | - Morten Frost
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Bo Abrahamsen
- Department of Medicine and Endocrinology, Holbaek Hospital, Holbaek, Denmark
- OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Steen Walter
- Department of Urology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lars Lund
- Department of Urology, Odense University Hospital, Odense, Denmark
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|