Effect of Bisphosphonates on Bone Mineral Density and Fracture Prevention in Gastric Cancer Patients After Gastrectomy

Lim, Jung Sub; Jin, Sung‐Ho; Kim, Sang Bum; Lee, Jong-Inn

doi:10.1097/mcg.0b013e31824f1af4

Cited by 14 publications

(11 citation statements)

References 28 publications

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“…Biphosphonates together with calcium and vitamin D are also very important in preventing osteoporosis and lowering the fracture rates. They have been shown to be effective in preventing skelatal related adverse events and should be considered in these patients [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Osteoporosis development and vertebral fractures after abdominal irradiation in patients with gastric cancer

et al. 2018

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BackgroundDecrease in bone mineral density, osteoporosis development, bone toxicity and resulting insufficiency fractures as late effect of radiotherapy are not well known. Osteoporosis development related to radiotherapy has not been investigated properly and insufficiency fractures are rarely reported for vertebral bones.MethodsNinety-seven patients with gastric adenocarcinoma were evaluated for adjuvant treatment after surgery. While 73 out of 97 patients treated with adjuvant chemoradiotherapy comprised the study group, 24 out of 97 patients with early stage disease without need of adjuvant treatment comprised the control group. Bone mineral densities (BMD) of lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry after surgery, and one year later in both groups.ResultsThere was statistically significant decline in BMDs after one year in each group itself, however the decline in BMDs of the patients in the irradiated group was more pronounced when compared with the patients in the control group; p values were 0.02 for the decline in BMDs of lumbar spine, and 0.01 for femoral neck respectively. Insufficiency fractures were observed only in the irradiated patients (7 out of 73 patients) with a cumulative incidence of 9.6%.ConclusionsAbdominal irradiation as in the adjuvant treatment of gastric cancer results in decrease in BMD and osteoporosis. Insufficiency fracture risk in the radiation exposed vertabral bones is increased. Calcium and vitamin D replacement and other measures for prevention of osteoporosis and insufficiency fractures should be considered after abdominal irradiation.

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Section: Discussionmentioning

confidence: 99%

Osteoporosis development and vertebral fractures after abdominal irradiation in patients with gastric cancer

et al. 2018

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“…In these studies, the incidence of postgastrectomy metabolic bone disorder varied widely due to the lack of established methods for evaluating osteoporosis. With the development of a useful method for evaluating osteoporosis (DXA) and effective agents for treatment (bisphosphonates), and also because the prevalence of osteoporosis is high after gastrectomy, bisphosphonates have been commonly administered to patients receiving gastrectomy prophylactically and therapeutically [10,22] . A previous study showed that risk factors for osteoporosis in patients undergoing gastrectomy were female gender and age >70 years, but not the type of gastrectomy (partial vs. total) or number of years after operation (<20 vs. ≥ 20 years) [23] .…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Intravenous Injection Form and Oral Jelly Form of Alendronate Sodium Hydrate for Bone Mineral Disorder after Gastrectomy

Kunisaki

Tanaka²,

Kubo³

et al. 2017

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Background/Aims: Osteoporosis is found to have high prevalence after gastrectomy and therefore, it is important to prevent this condition by means of effective medication, such as alendronate sodium hydrate. Methods: A total number of 48 gastric cancer patients diagnosed with osteoporosis after R0 gastrectomy was registered in this study between December 2013 and August 2014. Twenty-three patients received intravenous (i.v.) alendronate sodium hydrate and 25 patients received the drug in an oral jelly form. Serological and urinary examinations related to bone metabolism and bone mineral density (BMD) were performed periodically and the results obtained from the 2 groups were compared. Results: BMD increased, serum levels of bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase-5b, and the urine level of urine N-terminal telopeptide decreased with time in both groups. However, the serum Ca level did not change. Two-way analysis of variance revealed no significant differences in these factors between the 2 groups. Conclusion: It is essential to prevent both forms of osteoporosis by using alendronate sodium hydrate after gastrectomy for gastric cancer. A prospective, randomized, controlled trial in many patients following long duration should be conducted to clarify the benefits of i.v. alendronate sodium hydrate.

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“…In a small study of 47 post-gastrectomy patients, oral bisphosphonate treatment with alendronate or risedronate significantly reduced incident fractures and increased BMD at both the lumbar spine and femoral neck compared to no treatment (P<0.05 for all comparisons). (73)…”

Section: Other Malignanciesmentioning

confidence: 99%

Osteoporosis and Cancer

Drake

2013

Curr Osteoporos Rep

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Cancer is a major risk factor for bone loss and fractures. This is due both to direct effects of cancer cells on the skeleton and to deleterious effects of cancer-specific therapies on bone cells. Marked improvements in survival for many cancers mean that strategies to limit bone loss and reduce fracture risk must be incorporated into the care plans for nearly all patients with cancer. The vast majority of effort thus far has focused on bone loss in patients with breast and prostate cancers, with comparatively few studies in other malignancies. Anti-resorptive therapies have proven nearly universally effective for limiting bone loss in cancer patients, although few studies have been powered sufficiently to include fractures as primary endpoints, and patients are frequently neither identified nor treated according to published guidelines. Non-pharmacologic approaches to limit falls, particularly in elderly patients, are also likely important adjunctive measures for most cancer patients.

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Effect of Bisphosphonates on Bone Mineral Density and Fracture Prevention in Gastric Cancer Patients After Gastrectomy

Abstract: Therapy using bisphosphonates might be effective at increasing BMD and reducing fracture risk in gastric cancer patients after gastrectomy. Further well-designed randomized controlled trials are needed for confirmation.

Cited by 14 publications

References 28 publications

Osteoporosis development and vertebral fractures after abdominal irradiation in patients with gastric cancer

Osteoporosis development and vertebral fractures after abdominal irradiation in patients with gastric cancer

A Comparative Study of Intravenous Injection Form and Oral Jelly Form of Alendronate Sodium Hydrate for Bone Mineral Disorder after Gastrectomy

Osteoporosis and Cancer

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