title: Bone mineral density change during adjuvant chemotherapy in pediatric osteosarcoma.
abstract: OBJECTIVE
  Osteoporosis is currently receiving particular attention as a sequela in survivors of childhood osteosarcoma. The aim of this study was to evaluate bone mineral density (BMD) changes during methotrexate-based chemotherapy in children and adolescents with osteosarcoma.
  
  
  METHODS
  Nine patients with osteosarcoma were included in this retrospective study and compared with eight healthy controls. BMD of the lumbar spine and unaffected femur neck of patients was serially measured by dual-energy x-ray absorptiometry (DXA) before and just after chemotherapy and compared with controls.
  
  
  RESULTS
  Four patients (44%) showed decreased lumbar spine BMD and seven patients (78%) showed decreased femur neck BMD, while all controls showed increased lumbar and femur BMD (P=0.024 and P=0.023). The femur neck BMD z-scores decreased from -0.49±1.14 to -1.63±1.50 (P=0.032). At the end of therapy, five patients (56%) showed femur neck BMD z-scores below -2.0.
  
  
  CONCLUSIONS
  The bone metabolism is disturbed during therapy in children with osteosarcoma, resulting in a reduced BMD with respect to healthy controls. Since a reduced BMD predisposes to osteoporosis, specific attention and therapeutic interventions should be considered.
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Wan Hyeong
authors.initials: WH
authors.lastname: Cho
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Jun Ah
authors.initials: JA
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Ju-Hee
authors.initials: JH
authors.lastname: Seo
authors.affiliation: Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Jung Sub
authors.initials: JS
authors.lastname: Lim
keywords: Bone density; Korea; Osteoporosis; Osteosarcoma