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dc.contributor.authorFogelman, I
dc.contributor.authorBlake, G M
dc.contributor.authorBlamey, R
dc.contributor.authorPalmer, Michael K
dc.contributor.authorSauerbrei, W
dc.contributor.authorSchumacher, M
dc.contributor.authorSerin, D
dc.contributor.authorStewart, Alan L
dc.contributor.authorWilpshaar, W
dc.date.accessioned2009-08-21T14:33:34Z
dc.date.available2009-08-21T14:33:34Z
dc.date.issued2003-12
dc.identifier.citationBone mineral density in premenopausal women treated for node-positive early breast cancer with 2 years of goserelin or 6 months of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). 2003, 14 (12):1001-6 Osteoporos Inten
dc.identifier.issn0937-941X
dc.identifier.pmid14530912
dc.identifier.doi10.1007/s00198-003-1508-y
dc.identifier.urihttp://hdl.handle.net/10541/78228
dc.description.abstractThe purpose of this study was to compare changes in bone mineral density (BMD) in premenopausal patients with node-positive early breast cancer treated with goserelin (Zoladex) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Patients ( n=1640) were randomized to goserelin (3.6 mg every 28 days for 2 years) or CMF (sixx28-day cycles) treatment. In a protocoled sub-study involving 96 patients from eight centers (goserelin: n=53; CMF: n=43), lumbar spine (L2-L4) and femoral neck BMD were assessed by dual X-ray absorptiometry at baseline and then annually for 3 years. At the end of the 2-year goserelin-treatment period, mean BMD losses for goserelin-treated and CMF-treated patients were -10.5% and -6.5% ( P=0.0005) for lumbar spine and -6.4% and -4.5% ( P=0.04) for femoral neck, respectively. At 3 years, partial recovery of BMD was observed in goserelin recipients. In contrast, mean BMD losses for the CMF group indicated persistent BMD loss. No significant differences in BMD were observed between groups at the 3-year assessment of the spine or femoral neck. In the CMF group, based on amenorrhea status at 48 weeks, BMD losses at the lumbar spine were greater for amenorrheic than non-amenorrheic patients. Ovarian suppression resulting in amenorrhea was closely related to BMD loss in both treatment groups. Overall, patients who received CMF did not show recovery of BMD throughout follow-up, whereas partial recovery was observed 1 year after cessation of goserelin therapy, associated with the return of ovarian function in the majority of patients.
dc.language.isoenen
dc.subjectBreast Canceren
dc.subject.meshAdult
dc.subject.meshAmenorrhea
dc.subject.meshAntineoplastic Agents, Hormonal
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols
dc.subject.meshBone Density
dc.subject.meshBreast Neoplasms
dc.subject.meshCyclophosphamide
dc.subject.meshDrug Administration Schedule
dc.subject.meshFemale
dc.subject.meshFemur Neck
dc.subject.meshFluorouracil
dc.subject.meshGoserelin
dc.subject.meshHumans
dc.subject.meshLumbar Vertebrae
dc.subject.meshMethotrexate
dc.subject.meshPremenopause
dc.titleBone mineral density in premenopausal women treated for node-positive early breast cancer with 2 years of goserelin or 6 months of cyclophosphamide, methotrexate and 5-fluorouracil (CMF).en
dc.typeArticleen
dc.contributor.departmentDepartment of Nuclear Medicine, Guy's, Kings and St Thomas' Hospital Medical School, SE1 9RT, London, UK. ignac.fogelman@kcl.ac.uken
dc.identifier.journalOsteoporosis Internationalen
html.description.abstractThe purpose of this study was to compare changes in bone mineral density (BMD) in premenopausal patients with node-positive early breast cancer treated with goserelin (Zoladex) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Patients ( n=1640) were randomized to goserelin (3.6 mg every 28 days for 2 years) or CMF (sixx28-day cycles) treatment. In a protocoled sub-study involving 96 patients from eight centers (goserelin: n=53; CMF: n=43), lumbar spine (L2-L4) and femoral neck BMD were assessed by dual X-ray absorptiometry at baseline and then annually for 3 years. At the end of the 2-year goserelin-treatment period, mean BMD losses for goserelin-treated and CMF-treated patients were -10.5% and -6.5% ( P=0.0005) for lumbar spine and -6.4% and -4.5% ( P=0.04) for femoral neck, respectively. At 3 years, partial recovery of BMD was observed in goserelin recipients. In contrast, mean BMD losses for the CMF group indicated persistent BMD loss. No significant differences in BMD were observed between groups at the 3-year assessment of the spine or femoral neck. In the CMF group, based on amenorrhea status at 48 weeks, BMD losses at the lumbar spine were greater for amenorrheic than non-amenorrheic patients. Ovarian suppression resulting in amenorrhea was closely related to BMD loss in both treatment groups. Overall, patients who received CMF did not show recovery of BMD throughout follow-up, whereas partial recovery was observed 1 year after cessation of goserelin therapy, associated with the return of ovarian function in the majority of patients.


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