Bone health in patients with brain tumors.
BACKGROUND
Several factors, including the use of antiepileptic drugs, glucocorticoids, anticoagulants, chemotherapy, radiation therapy, and hemiplegia-associated osteopenia, render patients with brain tumor susceptible to bone disease.


METHODS
The authors review the pathophysiology of these factors and their impact upon bone integrity.


RESULTS
Steps that can be taken to minimize or eliminate bone morbidity including measurement of bone mineral density at treatment onset, adequate calcium intake, vitamins D and K supplementation, adequate sunlight exposure, weight-bearing exercises, fall prevention, avoidance of antiepileptic drugs linked to osteopenia, and judicious use and choice of glucocorticoids and anticoagulants are suggested.


CONCLUSIONS
Medical management of osteoporosis related to brain tumor treatment with bisphosphonates, teriparitide, and calcitonin is beneficial, as is kyphoplasty for symptomatic vertebral compression fractures.
Da Silva
Arnaldo Neves
AN
Neurology Department, University of Virginia, Charlottesville, VA 22908, USA. arnaldo@virginia.edu
Heras-Herzig
Ailleen
A
Schiff
David
D
D000925:Anticoagulants / Q000494:pharmacology*; D000927:Anticonvulsants / Q000494:pharmacology*; D000970:Antineoplastic Agents / Q000494:pharmacology; D015519:Bone Density / Q000187:drug effects / Q000528:radiation effects; D001851:Bone Diseases, Metabolic / Q000209:etiology*; D016723:Bone Remodeling / Q000187:drug effects*; D001932:Brain Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans