Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients

BMC Musculoskeletal Disorders

Research Article

Volker Vieth¹  Jendrik Hardes²  Georg Gosheger²  Joachim Boos³  Dieter Rosenbaum⁴  Corinna C Winter⁴  Carsten Müller⁴ 

[1] Department of Clinical Radiology, University Hospital Münster, Albert-Schweitzer.Str. 33, 48149, Münster, Germany;Department of General Orthopedics and Tumororthopedics, University Hospital Münster, Albert-Schweitzer.Str. 33, 48149, Münster, Germany;Department of Pediatric Oncology and Hematology, University Hospital Münster Albert-Schweitzer.Str. 33, 48149, Münster, Germany;Motion Analysis Lab, Department of General Orthopedics and Tumororthopedics, University Hospital Münster, Domagkstr. 3, 48149, Münster, Germany;

关键词: Bone Mineral Density;    Lumbar Spine Bone Mineral Density;    Areal Bone Mineral Density;    Osteosarcoma Patient;    Bone Mineral Density Loss;   

DOI  :  10.1186/1471-2474-11-287

 received in 2010-05-21, accepted in 2010-12-29,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundBone mineral density (BMD) accrual during childhood and adolescence is important for attaining peak bone mass. BMD decrements have been reported in survivors of childhood bone sarcomas. However, little is known about the onset and development of bone loss during cancer treatment. The objective of this cross-sectional study was to evaluate BMD in newly diagnosed Ewing's and osteosarcoma patients by means of dual-energy x-ray absorptiometry (DXA) after completion of neoadjuvant chemotherapy.MethodsDXA measurements of the lumbar spine (L2-4), both femora and calcanei were performed perioperatively in 46 children and adolescents (mean age: 14.3 years, range: 8.6-21.5 years). Mean Z-scores, areal BMD (g/cm2), calculated volumetric BMD (g/cm3) and bone mineral content (BMC, g) were determined.ResultsLumbar spine mean Z-score was -0.14 (95% CI: -0.46 to 0.18), areal BMD was 1.016 g/cm2 (95% CI: 0.950 to 1.082) and volumetric BMD was 0.330 g/cm3 (95% CI: 0.314 to 0.347) which is comparable to healthy peers. For patients with a lower extremity tumor (n = 36), the difference between the affected and non-affected femoral neck was 12.1% (95% CI: -16.3 to -7.9) in areal BMD. The reduction of BMD was more pronounced in the calcaneus with a difference between the affected and contralateral side of 21.7% (95% CI: -29.3 to -14.0) for areal BMD. Furthermore, significant correlations for femoral and calcaneal DXA measurements were found with Spearman-rho coefficients ranging from ρ = 0.55 to ρ = 0.80.ConclusionsThe tumor disease located in the lower extremity in combination with offloading recommendations induced diminished BMD values, indicating local osteopenia conditions. However, the results revealed no significant decrements of lumbar spine BMD in pediatric sarcoma patients after completion of neoadjuvant chemotherapy. Nevertheless, it has to be taken into account that bone tumor patients may experience BMD decrements or secondary osteoporosis in later life. Furthermore, the peripheral assessment of BMD in the calcaneus via DXA is a feasible approach to quantify bone loss in the lower extremity in bone sarcoma patients and may serve as an alternative procedure, when the established assessment of femoral BMD is not practicable due to endoprosthetic replacements.

【 授权许可】

CC BY   
© Müller et al; licensee BioMed Central Ltd. 2010