前列腺癌患者雄激素剥夺治疗后骨结构的改变使用髋关节DXA 3d建模

IF 3.5 2区医学 Q2 Medicine

Journal of Bone Oncology Pub Date : 2025-09-21 DOI:10.1016/j.jbo.2025.100713

Ji Yong Park , A Ram Hong , Jee Hee Yoon , Hee Kyung Kim , Ho-Cheol Kang , Seung Il Jung , Dongdeuk Kwon , Eu Chang Hwang

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引用次数: 0

摘要

前列腺癌雄激素剥夺治疗（ADT）对面骨矿物质密度（aBMD）有负面影响；然而，其对体积骨密度（vBMD）和骨几何形状的影响仍未得到充分研究。本研究旨在评估ADT治疗一年后aBMD、vBMD和髋关节结构分析（HSA）的变化。材料与方法本回顾性观察研究纳入41例接受ADT治疗1年的无骨转移前列腺癌患者，治疗前后均行双能x线吸收仪（DXA）检查。除aBMD外，还使用3D-Shaper软件在髋关节处评估小梁和皮质骨密度、整体骨密度（小梁+皮质）、皮质表面骨密度（sBMD）、皮质厚度和髋关节结构参数。结果患者平均年龄为75.5±6.8岁，体重指数为24.0±3.0 kg/m2。超过一半的患者Gleason评分为4或5分，大多数患者患有T3疾病。ADT治疗一年后，腰椎（-4.5±4.0%,P < 0.001）和全髋关节（-3.7±5.1%,P < 0.001）的aBMD显著降低。3D-DXA分析显示，全髋关节整体vBMD（-3.8±3.9%）和小梁vBMD（-4.9±7.4%）显著下降（P均为0.001），而皮质vBMD无显著变化（-1.6±6.0%,P = 0.062）。皮质sBMD显著下降-2.7±5.2% （P < 0.001）。全髋关节皮质厚度也显著降低（-1.2±3.2%,P = 0.011）。在髋关节结构参数方面，横截面积持续减小，股骨颈、股骨粗隆和股骨轴区域的屈曲率增加（均P <； 0.05），表明股骨易碎性增加，抗轴向力和压缩力降低。结论sadt对骨强度有明显的不利影响，导致aBMD、vBMD降低，HSA改变。3D-DXA可作为一种有价值且易于获取的工具，用于检测接受ADT的前列腺癌患者的骨结构变化。

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Alteration of bone architecture following androgen deprivation therapy in patients with prostate cancer using 3D-modeling from hip DXA

Introduction

Androgen deprivation therapy (ADT) for prostate cancer negatively affect areal bone mineral density (aBMD); however, its impact on volumetric BMD (vBMD) and bone geometry remains underexplored. This study aimed to evaluate changes in aBMD, vBMD, and hip structural analysis (HSA) following one year of ADT.

Materials and methods

This retrospective observational study included 41 patients with prostate cancer without bone metastasis who received ADT for one year and underwent dual-energy X-ray absorptiometry (DXA) both before and after treatment. In addition to aBMD, trabecular and cortical vBMD, integral vBMD (trabecular + cortical), cortical surface BMD (sBMD), cortical thickness, and hip structural parameters were assessed at the hip using 3D-Shaper software.

Results

The mean age and body mass index of the patients were 75.5 ± 6.8 years and 24.0 ± 3.0 kg/m², respectively. More than half had a Gleason score of 4 or 5, and the majority had T3 disease. After one year of ADT, significant reductions in aBMD were observed at the lumbar spine (–4.5 ± 4.0 %, P < 0.001) and total hip (–3.7 ± 5.1 %, P < 0.001). 3D-DXA analysis revealed significant declines in integral vBMD (–3.8 ± 3.9 %) and trabecular vBMD (–4.9 ± 7.4 %) (both P < 0.001), while cortical vBMD showed no significant change (–1.6 ± 6.0 %, P = 0.062) at the total hip. Cortical sBMD decreased significantly by –2.7 ± 5.2 % (P < 0.001). Cortical thickness also significantly decreased at the total hip (–1.2 ± 3.2 %, P = 0.011). With respect to hip structural parameters, cross-sectional area consistently decreased, and buckling ratio increased across the femoral neck, trochanteric, and shaft regions (all P < 0.05), indicating increased femoral fragility and reduced resistance to axial and compressive forces.

Conclusions

ADT exerts a substantial detrimental effect on bone strength, resulting in reductions in aBMD, vBMD, and alteration of HSA. 3D-DXA may serve as a valuable and accessible tool for detecting structural bone changes in prostate cancer patients undergoing ADT.

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来源期刊

Journal of Bone Oncology ONCOLOGY-

CiteScore

7.20

自引率

2.90%

发文量

审稿时长

34 days

期刊介绍： The Journal of Bone Oncology is a peer-reviewed international journal aimed at presenting basic, translational and clinical high-quality research related to bone and cancer. As the first journal dedicated to cancer induced bone diseases, JBO welcomes original research articles, review articles, editorials and opinion pieces. Case reports will only be considered in exceptional circumstances and only when accompanied by a comprehensive review of the subject. The areas covered by the journal include: Bone metastases (pathophysiology, epidemiology, diagnostics, clinical features, prevention, treatment) Preclinical models of metastasis Bone microenvironment in cancer (stem cell, bone cell and cancer interactions) Bone targeted therapy (pharmacology, therapeutic targets, drug development, clinical trials, side-effects, outcome research, health economics) Cancer treatment induced bone loss (epidemiology, pathophysiology, prevention and management) Bone imaging (clinical and animal, skeletal interventional radiology) Bone biomarkers (clinical and translational applications) Radiotherapy and radio-isotopes Skeletal complications Bone pain (mechanisms and management) Orthopaedic cancer surgery Primary bone tumours Clinical guidelines Multidisciplinary care Keywords: bisphosphonate, bone, breast cancer, cancer, CTIBL, denosumab, metastasis, myeloma, osteoblast, osteoclast, osteooncology, osteo-oncology, prostate cancer, skeleton, tumour.