open access

Vol 56, No 3 (2005)
Original papers
Published online: 2006-03-24
Submitted: 2013-02-15
Get Citation

Administration of 1α-OH vitamin D3 and calcium prevents bone mass loss in patients with advanced prostatic carcinoma after orchidectomy treated with complete androgenic blockade

Marek Tałałaj, Barbara Kapitan-Malinowska, Krzysztof Dębski, Robert Nowakowski, Ewa Marcinowska-Suchowierska, Alojzy Witeska
Endokrynologia Polska 2005;56(3):225-233.

open access

Vol 56, No 3 (2005)
Original papers
Published online: 2006-03-24
Submitted: 2013-02-15

Abstract

Complete androgenic blockade used in the treatment of advanced prostatic carcinoma can be attained by administration of antiandrogens in orchidectomized patients or by combined therapy with LH-RH analogs and antiandrogens. The treatment, however, decreases the influence of both androgens end estrogens on bone tissue and may result in bone mass loss and increased propensity to fractures. The purpose of the study was to determine the influence of complete androgenic blockade on bone mass and skeletal metabolism in men with advanced prostatic carcinoma and to assess whether 1α-OH vitamin D3 (1α-OHD3) together with calcium supplementation is able to prevent bone mass loss in men treated with complete androgenic blockade.
51 patients with advanced prostatic carcinoma, with skeletal metastases, aged 44-86, mean 68 ys were included into a 12-month prospective study. All patients were treated with orchidectomy followed by therapy with flutamide in a dose of 750 mg daily. 26 patients were additionally given 1α-OHD3 in a dose of 0.5 µg/d and calcium carbonate in an initial dose of 1 g daily. It was found that the 12-month treatment with complete androgenic blockade resulted in a decrease in bone mineral density (BMD) by 8.1% in the lumbar spine, by 6.3% in the femoral neck and by 3.5% in the total skeleton. Therapy with 1α-OHD3 and CaCO3 caused complete inhibition of bone tissue loss in the lumbar spine and resulted in an increase in BMD by 2.2% in femoral neck and by 1.9% in the total skeleton. None of the examined patients experienced any skeletal fractures. In both groups of patients a prompt decrease in serum alkaline phosphatase activity - a marker of osteoblast activity and an increase in fasting urine calcium creatinine ratio indicating acceleration of bone resorption were found.
Conclusions: in patients with advanced prostatic carcinoma treated with complete androgenic blockade acceleration of bone mass loss is observed; treatment with 1α-OHD3 and CaCO3 is able to prevent both trabecular and compact bone loss.

Abstract

Complete androgenic blockade used in the treatment of advanced prostatic carcinoma can be attained by administration of antiandrogens in orchidectomized patients or by combined therapy with LH-RH analogs and antiandrogens. The treatment, however, decreases the influence of both androgens end estrogens on bone tissue and may result in bone mass loss and increased propensity to fractures. The purpose of the study was to determine the influence of complete androgenic blockade on bone mass and skeletal metabolism in men with advanced prostatic carcinoma and to assess whether 1α-OH vitamin D3 (1α-OHD3) together with calcium supplementation is able to prevent bone mass loss in men treated with complete androgenic blockade.
51 patients with advanced prostatic carcinoma, with skeletal metastases, aged 44-86, mean 68 ys were included into a 12-month prospective study. All patients were treated with orchidectomy followed by therapy with flutamide in a dose of 750 mg daily. 26 patients were additionally given 1α-OHD3 in a dose of 0.5 µg/d and calcium carbonate in an initial dose of 1 g daily. It was found that the 12-month treatment with complete androgenic blockade resulted in a decrease in bone mineral density (BMD) by 8.1% in the lumbar spine, by 6.3% in the femoral neck and by 3.5% in the total skeleton. Therapy with 1α-OHD3 and CaCO3 caused complete inhibition of bone tissue loss in the lumbar spine and resulted in an increase in BMD by 2.2% in femoral neck and by 1.9% in the total skeleton. None of the examined patients experienced any skeletal fractures. In both groups of patients a prompt decrease in serum alkaline phosphatase activity - a marker of osteoblast activity and an increase in fasting urine calcium creatinine ratio indicating acceleration of bone resorption were found.
Conclusions: in patients with advanced prostatic carcinoma treated with complete androgenic blockade acceleration of bone mass loss is observed; treatment with 1α-OHD3 and CaCO3 is able to prevent both trabecular and compact bone loss.
Get Citation

Keywords

prostatic carcinoma; androgenic blockade; alphacalcidiol; bone mineral density

About this article
Title

Administration of 1α-OH vitamin D3 and calcium prevents bone mass loss in patients with advanced prostatic carcinoma after orchidectomy treated with complete androgenic blockade

Journal

Endokrynologia Polska

Issue

Vol 56, No 3 (2005)

Pages

225-233

Published online

2006-03-24

Bibliographic record

Endokrynologia Polska 2005;56(3):225-233.

Keywords

prostatic carcinoma
androgenic blockade
alphacalcidiol
bone mineral density

Authors

Marek Tałałaj
Barbara Kapitan-Malinowska
Krzysztof Dębski
Robert Nowakowski
Ewa Marcinowska-Suchowierska
Alojzy Witeska

Important: This website uses cookies.tanya dokter More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl