Bone fractures associated with luteinizing hormone-releasing hormone agonists used in the treatment of prostate carcinoma.
BACKGROUND
Luteinizing hormone-releasing hormone agonists (LHRH-a) have become an established treatment for certain patients with prostate carcinoma. LHRH-a are known to decrease bone mineral density. The purpose of this study was to determine the risk of bone fracture in men receiving LHRH-a for prostate carcinoma.


METHODS
A retrospective chart review and phone interviews were conducted to determine the incidence of bone fractures occurring in patients receiving LHRH-a for the treatment of prostate carcinoma. Abstracted data included the number of monthly LHRH-a injections, age, clinical stage of disease, sites of metastases, and bone fracture history.


RESULTS
Twenty of the 224 patients (9%) treated with LHRH-a for prostate carcinoma between 1988 and 1995 at 3 teaching hospitals had at least 1 bone fracture during treatment with LHRH-a. The duration of treatment to the time of fracture ranged from 1 to 96 months (mean, 22.2 months). Seven fractures (32%) were osteoporotic in nature (i.e., vertebral compression fractures or hip fractures after a fall from standing), whereas 8 fractures (36%) were associated with a significant traumatic event (i.e., a motor vehicle accident, boxing, etc.) and 5 were of mixed etiology. Two of 22 fractures (9%) were pathologic.


CONCLUSIONS
This study demonstrated a 9% fracture incidence in a cohort of patients receiving LHRH-a for prostate carcinoma for up to 96 months. The incidence of osteoporotic fractures was 5%.
Townsend
M F
MF
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Sanders
W H
WH
Northway
R O
RO
Graham
S D
SD
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D005598:Fractures, Spontaneous / Q000209:etiology*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D015994:Incidence; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors
D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone