goserelin and Spinal-Fractures

We determined the risk factors for osteoporosis and spinal fractures in men with prostate cancer receiving androgen deprivation therapy.. We performed a retrospective analysis of 87 consecutive men with prostate cancer receiving androgen deprivation therapy referred for evaluation of osteoporosis. Data were comprised of lateral thoracolumbar radiographs, bone densitometry, serum biochemistry and a detailed assessment of osteoporotic risk factors. Multivariate regression analysis was used to determine the major risk factors for osteoporosis and spinal fractures.. There were 38 (44%) men who were 74.5 years old with radiographic evidence of spinal fractures. They had an initial mean prostate specific antigen of 52.8 ng/ml and had received androgen deprivation therapy for a mean of 39.6 months (95% confidence interval 28.7 to 50.4). Mean spinal (quantitative computerized tomography t-score -4.2) and femoral neck bone mineral densities (dual energy x-ray absorptiometry t-score -2.1) were significantly lower than in men without spinal fractures (p < 0.001 for all measurements). In the regression analysis the duration of androgen deprivation therapy (p = 0.002), serum 25-hydroxyvitamin D levels (p = 0.003) and a history of alcohol excess (defined as more than 4 standard drinks daily, p = 0.04) were the main determinants of spinal fractures.. Prolonged androgen deprivation therapy, low serum 25-hydroxyvitamin D levels and a history of alcohol excess are important risk factors for osteoporosis and spinal fractures in men with prostate cancer.

Topics: Aged; Alcohol Drinking; Androgen Antagonists; Anilides; Antineoplastic Agents, Hormonal; Comorbidity; Flutamide; Goserelin; Humans; Male; Multivariate Analysis; Nitriles; Osteoporosis; Prostatic Neoplasms; Retrospective Studies; Risk Factors; Spinal Fractures; Time Factors; Tosyl Compounds; Vitamin D

We report 3 patients referred to the bone clinic after spinal fractures. Dual energy X-ray absorptiometry showed severe osteoporosis. Each patient was found to have a history of prostatic carcinoma and long-term treatment with goserelin. We suggest that all patients who have received androgen deprivation therapy for more than 1 year should be evaluated by bone densitometry.

Topics: Aged; Aged, 80 and over; Antineoplastic Agents, Hormonal; Carcinoma; Densitometry; Femoral Fractures; Follow-Up Studies; Fractures, Spontaneous; Goserelin; Humans; Male; Osteoporosis; Prostatic Neoplasms; Risk Assessment; Severity of Illness Index; Spinal Fractures; Thoracic Vertebrae