乳腺癌治疗相关的骨成分丢失及其防治

全身辅助治疗在一定程度上降低了乳腺癌死亡率,但也对骨代谢带来不良影响,导致骨成分丢失增加,并可引起骨质疏松症及骨折。这些不良反应主要由内分泌改变介导,如化疗和卵巢切除导致的早期停经、芳香化酶抑制剂对绝经后循环雌激素的抑制,此外化疗也可能对骨细胞功能产生直接影响。随着支持芳香化酶抑制剂治疗的临床资料的出现,乳腺癌患者的骨健康正成为颇受关注的热点问题。本文综述了乳腺癌相关治疗与骨质疏松症的关系以及其防治。

Treatment of bone loss associated with breast cancer: a review

The widespread use of adjuvant systemic therapy, to some extent, contributes to the steady fall in the mortality of early breast cancer patients over recent years. However, some of the treatments have adverse effects on the bone metabolism with increased bone loss which may result in osteoporosis and associated fractures. Most of the effects on the bone are mediated by endocrine changes, either induction of an early menopause by chemotherapy and ovarian ablation, or further suppression of postmenopausal circulating estrogens by aromatase inhibitors. Chemotherapy may also have direct effects on bone cell function. Bone health of breast cancer patients is a highly topical issue with increasing data supporting the use of aromatase inhibitors in recent years.