title: Changes in bone mineral density in uterine cervical cancer patients after radiation therapy.
abstract: OBJECTIVE
  To prospectively investigate the changes in bone mineral density (BMD) after pelvic radiation therapy in patients with uterine cervical cancer.
  
  
  METHODS
  Of 52 cervical cancer patients who received pelvic RT in our university hospital between 2009 and 2011, 46 patients without recurrence and who were followed up for more than 12 months were included in the study. The BMD of the irradiated region and nonirradiated regions, serum estradiol, tartrate-resistant acid phosphatase-5b, and N-terminal cross-linking telopeptide of collagen 1 were measured before, at 3 months after, and at 12 months after RT. The patient cohort was divided into 2 groups according to estradiol level before RT, and the groups were defined as postmenopausal (<40 pg/mL) and premenopausal (≥40 pg/mL).
  
  
  RESULTS
  The mean BMDs within the irradiation field (lumbar vertebra 5) in the postmenopausal and the premenopausal groups were 0.825 and 0.910 g/cm(2) before RT and 0.746 and 0.841 g/cm(2) 12 months after RT, respectively. Significant decreases were observed in both groups (P<.05 and P<.01, respectively). In addition, in the premenopausal group the mean BMDs of the nonirradiated regions at thoracic vertebrae 9-12 and lumbar vertebrae 2-4 were 0.753 and 0.958 g/cm(2) before RT and were significantly decreased to 0.706 and 0.921 g/cm(2) 12 months after RT (P<.01 and P<.05, respectively). Estradiol significantly decreased 3 months after RT, whereas tartrate-resistant acid phosphatase-5b and N-terminal cross-linking telopeptide of collagen 1 continued to increase over time in the premenopausal group.
  
  
  CONCLUSIONS
  A decrease in BMD in the irradiated region after RT was observed within 1 year, regardless of menopausal status. Furthermore, in premenopausal patients, pelvic RT caused a decrease in systemic BMD.
authors.affiliation: Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Okonogi
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Saitoh
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Noda
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.forename: Takahiro
authors.initials: T
authors.lastname: Oike
authors.forename: Yu
authors.initials: Y
authors.lastname: Ohkubo
authors.forename: Ken
authors.initials: K
authors.lastname: Ando
authors.forename: Hiro
authors.initials: H
authors.lastname: Sato
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
mesh_terms: D000135:Acid Phosphatase / Q000097:blood; D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000494:pharmacology; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects*; D001842:Bone and Bones / Q000378:metabolism; D001918:Brachytherapy / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy; D024042:Collagen Type I / Q000097:blood; D003131:Combined Modality Therapy / Q000379:methods; D004967:Estrogens / Q000097:blood; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000528:radiation effects*; D008875:Middle Aged; D010388:Pelvis; D010455:Peptides / Q000097:blood; D017698:Postmenopause / Q000097:blood; D017697:Premenopause / Q000097:blood; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D000071681:Tartrate-Resistant Acid Phosphatase; D013904:Thoracic Vertebrae / Q000503:physiopathology; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D024042:Collagen Type I; D004967:Estrogens; D007527:Isoenzymes; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase