title: Bone mineral loss induced by anticancer treatment for gynecological malignancies in premenopausal women.
abstract: OBJECTIVE
  Although surgical menopause may increase the risks of osteoporosis, few studies have investigated the influence of chemotherapy and radiation therapy. The aim of this study is to evaluate the effects of treatments for gynecological malignancies on bone mineral density (BMD).
  
  
  METHODS
  This study enrolled 35 premenopausal women (15 ovarian cancers (OCs), 9 endometrial cancers (ECs), and 11 cervical cancers (CCs)) who underwent surgical treatment that included bilateral oophorectomy with or without adjuvant platinum-based chemotherapy in OC and EC patients, or concurrent chemo-radiation therapy (CCRT) in CC patients according to the established protocols at the Osaka Medical College Hospital between 2006 and 2008. The BMD of the lumbar spine (L1-L4) was measured by dual-energy X-ray absorptiometry, and urine cross-linked telopeptides of type I collagen (NTx) and bone alkaline phosphatase (BAP) were assessed for evaluation of bone resorption and bone formation respectively. These assessments were performed at baseline and 12 months after treatment.
  
  
  RESULTS
  Although the serum BAP was significantly increased only in the CC group, a rapid increase in the bone resorption marker urinary NTx was observed in all groups. The BMD, 12 months after CCRT was significantly decreased in the CC group at 91.9±5.9% (P<0.05 in comparison to the baseline).
  
  
  CONCLUSIONS
  This research suggests that anticancer therapies for premenopausal women with gynecological malignancies increase bone resorption and may reduce BMD, particularly in CC patients who have received CCRT. Therefore, gynecologic cancer survivors should be educated about these potential risks and complications.
authors.affiliation: Department of Obstetrics and Gynecology Osaka Medical College 2-7 Daigaku-machi, Takatsuki-city, Osaka, 569-8686 Japan.
authors.forename: Keina
authors.initials: K
authors.lastname: Nishio
authors.forename: Akiko
authors.initials: A
authors.lastname: Tanabe
authors.forename: Risa
authors.initials: R
authors.lastname: Maruoka
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takai
authors.forename: Tatsuharu
authors.initials: T
authors.lastname: Sekijima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tunetoh
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Terai
authors.forename: Masahide
authors.initials: M
authors.lastname: Ohmichi
keywords: bone mineral density; cervical cancer; concurrent chemo-radiation therapy; surgical menopause