化疗对乳腺癌患者骨密度的影响

Effects of chemotherapy on bone mineral density in patients with breast cancer

目的探讨化疗(药物治疗)对乳腺癌患者骨密度的影响及可能的机制。方法 68例乳腺癌患者(绝经前28例,绝经后40例)和50例正常对照。乳腺癌患者术后均常规化疗。其中绝经前患者化疗结束后按月经状况分为:A组16例,化疗结束后继续行经;B组12例,化疗结束后停经。所有研究对象均测量基线骨密度(BMD);用双能X线吸收测定仪(DEXA)测量腰椎和左髋部位的BMD,分别比较肿瘤组化疗前、后,A组与B组化疗结束后BMD的变化。结果肿瘤组化疗后腰椎和左髋部位的BMD比化疗前均显著降低(P<0.05);B组化疗结束后较A组化疗结束后腰椎和左髋部位的BMD均有明显降低(P<0.05)。结论化疗导致乳腺癌患者骨量早期丢失。对于绝经前的患者,卵巢功能衰竭是引起骨量丢失最重要的原因。

Objective To study the effect and possible mechanism of chemotherapy （drug treatment） on bone mineral density in patients with breast cancer. Methods 68 cases of breast cancer patients （28 cases before menopause, postmeno-pansal 40 cases） and 50 cases of normal controls. Used in postoperative patients with conventional chemotherapy. Premenopausal patients with chemotherapy by menstrual status after the end of which is divided into： a group of 16 cases, continued after the end of chemotherapy; B 19 cases, chemotherapy after the menopause. All study participants were measured baseline bone mineral density （BMD） , with dual energy x ray absorption measurement instrument （DEXA） measuring BMD of lumbar and left part of the hip, after chemotherapy of tumor before chemotherapy group, respectively, group a and group b after the end of chemotherapy at the end of chemotherapy of BMD changes. Results After chemotherapy of tumor group of BMD at lumbar and left hip parts are significantly lower than before the chemotherapy （ P 〈 0.05 ） ; End of the b group than group a at the end chemotherapy after lumbar and left part of the hip BMD have significantly reduced （ P 〈 0. 05 ）. Conclusion Result in loss of bone mass in patients with early breast cancer chemotherapy. For premenopausal patients, bone loss due to ovarian failure is the most important reason.