2005 Volume 31 Issue 3 Pages 203-210
Hormonal therapy (androgen deprivation therapy) is the standard treatment for controlling prostate cancer, but adverse effects on bone health have been reported frequently. The aim of the present study was to evaluate the severity of progressive bone loss due to androgen deprivation therapy for prostate cancer through a meta-analysis. Relevant articles on this topic were selected using the Medline database and manual searches, and randomized controlled trials and open-labeled uncontrolled trials were performed. The overall mean loss in bone mineral density was estimated as the weighted mean of the percentage change from the initial bone density. The results of our systematic review showed that bone mineral density had decreased by 2.8 % at the femoral neck, by 2.7 % at the lumbar spine, and by 1.5% at the hip after 12 months of androgen deprivation therapy. The degree of the effect of androgen deprivation therapy versus the control was estimated to be 0.62 (95 % confidence interval, 0.24 to 0.99 ; P=0.002) at the femoral neck ; 0.58 (0.20 to 0.97 ; P = 0.003) at the lumbar spine ; and 0.89 (0.47 to 1.32 ; P< 0.001) at the hip. These results provide evidence that androgen deprivation therapy for prostate cancer results in a rapid loss of bone mineral density, and increases the risk of osteoporosis and related fractures. In order to prevent this, it may be necessary to monitor the bone mineral density before and during therapy and administer agents that stimulate bone metabolism.
