title: Chemotherapy- and irradiation-induced bone loss in adults with solid tumors.
abstract: It is estimated that bone loss occurs in 70 % of all patients dying from cancer, causing a significant disease burden in cancer patients. Bone loss is caused by cancer itself and its metastases, but also by cancer therapies. Of the cancer therapy-induced bone loss, hormone therapies are best known for their bone damaging abilities. However, chemo- and radiotherapy may result in bone loss too. In this review, direct and indirect effects of various chemotherapies (such as methotrexate, imatinib, and taxanes) that cause bone loss are discussed. Furthermore, we discuss bone loss caused by radiotherapy and radionuclides, of which the latter may be reduced with the introduction of the alpha-emitter Radium-223. Finally, agents preventing chemotherapy- or radiotherapy-induced bone loss, in particular denosumab and bisphosphonates, are being reviewed for their efficacy in preventing chemotherapy- and irradiation-induced bone loss in cancer patients.
authors.affiliation: Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, The Netherlands, m.d.wissing@lumc.nl.
authors.forename: Michel D
authors.initials: MD
authors.lastname: Wissing
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001862:Bone Resorption / Q000209:etiology* / Q000517:prevention & control; D000069448:Denosumab / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D004358:Drug Therapy; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications*; D006801:Humans; D000068877:Imatinib Mesylate / Q000009:adverse effects / Q000627:therapeutic use; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D011868:Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D011878:Radiotherapy / Q000009:adverse effects*; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D004164:Diphosphonates; D011868:Radioisotopes; D043823:Taxoids; D000069448:Denosumab; D000068877:Imatinib Mesylate; D008727:Methotrexate