Ann Pediatr Endocrinol Metab.  2015 Sep;20(3):150-154. 10.6065/apem.2015.20.3.150.

Bone mineral density change during adjuvant chemotherapy in pediatric osteosarcoma

• Ahn JH
• Cho WH
• Lee JA
• Kim DH
• Seo JH
• Lim JS

• KMID: 2150391
• DOI: http://doi.org/10.6065/apem.2015.20.3.150

Abstract

PURPOSE
Osteoporosis is currently receiving particular attention as a sequela in survivors of childhood osteosarcoma. The aim of this study was to evaluate bone mineral density (BMD) changes during methotrexate-based chemotherapy in children and adolescents with osteosarcoma.
METHODS
Nine patients with osteosarcoma were included in this retrospective study and compared with eight healthy controls. BMD of the lumbar spine and unaffected femur neck of patients was serially measured by dual-energy x-ray absorptiometry (DXA) before and just after chemotherapy and compared with controls.
RESULTS
Four patients (44%) showed decreased lumbar spine BMD and seven patients (78%) showed decreased femur neck BMD, while all controls showed increased lumbar and femur BMD (P=0.024 and P=0.023). The femur neck BMD z-scores decreased from -0.49+/-1.14 to -1.63+/-1.50 (P=0.032). At the end of therapy, five patients (56%) showed femur neck BMD z-scores below -2.0.
CONCLUSION
The bone metabolism is disturbed during therapy in children with osteosarcoma, resulting in a reduced BMD with respect to healthy controls. Since a reduced BMD predisposes to osteoporosis, specific attention and therapeutic interventions should be considered.

Keyword

Osteosarcoma; Osteoporosis; Bone density; Korea

MeSH Terms

Absorptiometry, Photon
Adolescent
Bone Density*
Chemotherapy, Adjuvant*
Child
Drug Therapy
Femur
Femur Neck
Humans
Korea
Metabolism
Osteoporosis
Osteosarcoma*
Retrospective Studies
Spine
Survivors

Figure

• 

  Fig. 1 Comparison of bone mineral density (BMD) changes between osteosarcoma patients and controls. (A) Lumbar spine BMD (mg/cm2) changes of patients. (B) Femur neck BMD changes of patients. (C) Lumbar spine BMD changes of controls. (D) Femur neck BMD changes of controls. Four patients showed decreased lumbar spine BMD and 7 patients showed decreased femur neck BMD, while all controls showed increased BMDs. The interval from first BMD evaluation to next BMD evaluation was 7.8±1.7 months (vs. 12.0±0.5 months in controls).

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