A Retrospective Analysis Of The Application Of Bisphosphonate In Skeletal-related Events Of Prostate Cancer After ADT

Background:With the aging of China's population increasing,the incidence of prostate cancer was significantly higher than before.Since prostate cancer is associated with testosterone stimulation,most prostate cancers are androgen-dependent.On the basis of these theories,in the majority of cases clinic will choose androgen deprivation therapy as one of the treatment options for patients with hormone-dependent prostate cancer.However,lower androgen level caused by the androgen deprivation therapy could result in bone loss.So patients often have skeletal related events like osteoporosis,Intractable osteodynia,fragile fracture.Those increase treatment expense and reduce the quality of life,even lead to death.Therefore,it becomes an emergency problem how to prevents or treat bone mineral density reducing after androgen deprivation therapy.Objective:To investigate the correlation between serum testosterone level and T value level in patients with non-metastatic prostate cancer,and evaluate the effects of bisphosphonate on T value level and bone markers in non-metastatic androgen deprivation therapy treated with androgen removal,and observe the security of both applications.Materials and Methods:This study collected 328 prostate cancer patients(after ADT)diagnosed by pathology.Selecting 117 prostate cancer patients with osteoporosis/bone loss,their serum testosterone level was measured by chemiluminescence and T value was measured by dual energy X-ray absorptiometry(DXA).According to whether using the bisphosphonate,they were divided into three groups(Group A,B and C).Correlation analysis was used to evaluate the relationship between testosterone and T value level,analysis of Variance and t test were used to analyze the changes of T value,P1 NP and ?-CTX,and to compare the improvement of bone pain and incidence of adverse reactions.Result:1.Correlation analysis showed that the serum testosterone level in 117 patients with androgen removal was significantly positively correlated with T value level(R=0.957,P<0.05).2.The comparative analysis showed that before the treatment,the level of T value and bone metabolite among the three groups were no statistically significant difference(P>0.05).After the treatment,the level of T value in group A and group B were higher than group C(P<0.05),and P1 NP and ?-CTX level in group C was higher than group A and B.3.The intra-block analysis showed that in group A and B,the level of T value got higher and the P1 NP and ?-CTX became lower after the treatment.In group C,however,had the totally opposite effect.All the differences were statistically significant(P<0.05)4.For the patients in group A and B,the pain has been obvious relieved after the treatment but there was no significant improvement for group C(P=0.374).5.As for the rate of untoward effect,there was no statistically significant difference among the three groups(P>0.05).Conclusions:1.After androgen deprivation therapy,the morbidity of osteopenia and osteoporosis gets high in prostate cancer patients because of the decrease of serum testosterone level.There should pay more attention to monitor the changes in bone density,preventsing the occurrence of skeletal related events,improving the prognosis of patients and treatment effects,reducing the risk of osteoporosis.2.For the patients,who suffered from osteoporosis due to androgen deprivation therapy,the application of zoledronate and alendronate sodium has important clinical value.3.Zoledronate and alendronate sodium can be used as the initial therapy,for their better toleration,higher safety and less adverse reaction.