The Effects Of Chemotherapy On Bone Metabolism In Breast Cancer Patients

Objective:To investigate the influence of post surgery chemotherapies on bone metabolism in breast cancer patients,to study bone scintigraphy in evaluating the bone metabolism for breast cancer patients with post surgery chemotherapy.Methods:Sixty consecutive patients with breast cancer under 50 years were recruited for the study.Thirty cases per group received ET and ECT.Semi-quantitative analysis by ROI technique from bone scintigraphy before and after chemotherapy,the bone mineral density(BMD) from dual-energy X ray examination on lumbar and femur,alkaline phosphatase(ALP)) and urine calcium were compared in patients with different chemotherapeutic medications.Results:The baseline characteristics are similar among two groups before chemotherapy. No significant difference of BMD of lumbar and femur were observed in breast cancer patients before,after 3 and 6 courses of treatment chemotherapy in patients treated with ET(F values were 1.42,1.73,p＞0.05).Significant differences of BMD of lumbar and femur were observed in patients treated with ECT(F values were 5.36,4.37,p＜0.05,Q values were 0.64,0.88,p＞0.05;6.11,7.02,8.12,7.54,p＜0.05).Significant differences of radioactivity counts of ROI of skull and femur were observed in breast cancer patients before,after 3 and 6 courses of treatment chemotherapy in patients treated with ET and ECT(F values were 9.42,10.94,17.47,19.64,p＜0.05).However,no significant difference of radioactivity counts of ROI of skull and femur were observed between patients after 3 and 6 courses of treatment chemotherapy in patients treated with ET(Q values were 1.12,0.74,P＞0.05) Significant differences of ALP and urine calcium were observed in breast cancer patients before,after 3 and 6 courses of treatment chemotherapy,and in patients treated with ET,and ECT(F values were 12.56,42.61,14.78,p均＜0.05 ).However,no significant difference of ALP was found between patients after 3 and 6 courses of treatment chemotherapy in patients treated with ET(F values was 1.56,P＞0.05).Additionally,we also found significant difference of positive rate diagnosed as osteoporosis by BMD and bone scintigraphy in breast cancer patients between 3 and 6 courses of treatment chemotherapy with ET and ECT(u values were 5.81,3.38,6.34,3.05,20.16,11.69,9.25,p＜0.05).Conclusion:Post surgery chemotherapy has great effects on bone metabolism in breast cancer patients,which is characterized by increased bone absorption,bone loss.Bone scintigraphy is a necessarily complementary to BMD and biochemical method in evaluating the abnormality of bone metabolism,and is highly effective in early detecting chemotherapy-caused bone loss with osteopenia,osteoporosis and osteoporosis caused bone fracture.