Chemotherapy- and irradiation-induced bone loss in adults with solid tumors.

Michel D Wissing

doi:10.1007/s11914-015-0266-z

Abstract

It is estimated that bone loss occurs in 70 % of all patients dying from cancer, causing a significant disease burden in cancer patients. Bone loss is caused by cancer itself and its metastases, but also by cancer therapies. Of the cancer therapy-induced bone loss, hormone therapies are best known for their bone damaging abilities. However, chemo- and radiotherapy may result in bone loss too. In this review, direct and indirect effects of various chemotherapies (such as methotrexate, imatinib, and taxanes) that cause bone loss are discussed. Furthermore, we discuss bone loss caused by radiotherapy and radionuclides, of which the latter may be reduced with the introduction of the alpha-emitter Radium-223. Finally, agents preventing chemotherapy- or radiotherapy-induced bone loss, in particular denosumab and bisphosphonates, are being reviewed for their efficacy in preventing chemotherapy- and irradiation-induced bone loss in cancer patients.

Highlights

Cancer is one of the most prevalent and deadliest diseases in the world, with an estimated 1.7 million new cases and 586, 000 deaths in the USA in 2014 [1]
Bone disease primarily occurs due to bone metastases: lung carcinomas, causing most cancer deaths in both men and women [1], as well as prostate and breast cancer, the most prevalent cancers in men and women, respectively [3], frequently metastasize to the bones; other solid tumors metastasize to bones as well [2]
In prostate cancer patients who received long-term androgendeprivation therapy, osteoporosis rates increased from 35.4 % in hormone-naive patients to 80.6 % of patients treated with androgen-deprivation therapy for ten or more years [6]

Summary

Introduction

Cancer is one of the most prevalent and deadliest diseases in the world, with an estimated 1.7 million new cases and 586, 000 deaths in the USA in 2014 [1]. It is well known that hormonal suppression by hormone ablation therapy, frequently used in patients with among others prostate and breast cancer, results in osteoporosis and bone fractures due to a decrease in bone mineral density [5]. Treatment of cancer patients with other therapies, such as radio- and chemotherapy, may result in significant bone loss as well.

Results

Conclusion