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A Prospective Observational Study on Effect of Short-Term Periodic Steroid Premedication on Bone Metabolism in Gastrointestinal Cancer (ESPRESSO-01)

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Title: A Prospective Observational Study on Effect of Short-Term Periodic Steroid Premedication on Bone Metabolism in Gastrointestinal Cancer (ESPRESSO-01)
Authors: Nakamura, Michio Browse this author
Ishiguro, Atsushi Browse this author
Muranaka, Tetsuhito Browse this author
Fukushima, Hiraku Browse this author
Yuki, Satoshi Browse this author
Ono, Kota Browse this author →KAKEN DB
Murai, Taichi Browse this author
Matsuda, Chika Browse this author
Oba, Ayane Browse this author
Itaya, Kazufumi Browse this author
Sone, Takayuki Browse this author
Yagisawa, Masataka Browse this author
Koike, Yuta Browse this author
Endo, Ayana Browse this author
Tsukuda, Yoko Browse this author
Ono, Yuji Browse this author
Kudo, Takahiko Browse this author
Nagasaka, Atsushi Browse this author
Nishikawa, Shuji Browse this author
Komatsu, Yoshito Browse this author →KAKEN DB
Keywords: bone alkaline phosphatase
bone mineral density
gastrointestinal cancer
steroid-induced osteoporosis
glucocorticoid premedication
Issue Date: May-2017
Publisher: AlphaMed Press
Journal Title: The Oncologist
Volume: 22
Issue: 5
Start Page: 592
End Page: 600
Publisher DOI: 10.1634/theoncologist.2016-0308
Abstract: Background. A multicenter prospective observational study evaluated the effect of gastrointestinal cancer chemotherapy with short‐term periodic steroid premedication on bone metabolism. Patients and Methods. Seventy‐four patients undergoing chemotherapy for gastrointestinal cancer were studied. The primary endpoints were changes in bone mineral densities (BMDs) and metabolic bone turnover 16 weeks after initiation of chemotherapy. BMDs, measured by dual‐energy x‐ray absorptiometry, and serum cross‐linked N‐telopeptides of type I collagen (sNTX), and bone alkaline phosphatase (sBAP) were assessed for evaluation of bone resorption and formation, respectively. Results. In 74.3% (55/74) of the patients, BMDs were significantly reduced at 16 weeks relative to baseline. The percent changes of BMD were -1.89% (95% confidence interval [CI], -2.67% to -1.11%: p < .0001) in the lumbar spine, -2.24% (95% CI, -3.59% to -0.89%: p = .002) in the total hip, and -2.05% (95% CI, -3.11% to -0.99%: p < .0001) in the femoral neck. Although there was no significant difference in sNTX levels during 16 weeks (p = .136), there was a significant increase in sBAP levels (p = .010). Decreased BMD was significantly linked to number of chemotherapy cycles (p = .02). There were no significant correlations between changes in BMDs and the primary site of malignancy, chemotherapy regimens, total cumulative steroid dose, steroid dose intensity, and additive steroid usage. Conclusion. Gastrointestinal cancer chemotherapy with periodic glucocorticoid premedication was associated with reduced BMD and increased sBAP levels, which were linked to number of chemotherapy cycles but independent of primary site, chemotherapy regimen, duration, and additive steroid usage.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 小松 嘉人

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