Opportunistic osteoporosis screening using routine computed tomography images to identify bone loss in gynecologic cancer survivors. Issue 8 (31st January 2022)

• Record Type: Journal Article
• Authors: Sobecki, Janelle; Weigman, Benjamin; Anderson-Carter, India; Barroilhet, Lisa; Chandereng, Thevaa; Kliewer, Mark; Hartenbach, Ellen
• Is Part Of: International journal of gynecological cancer. Volume 32:Issue 8(2022)
• Page Start: 1050
• Page End: 1055
• Publication Date: 2022-01-31
• Subjects: quality of Life (PRO)/palliative care -- uterine cancer -- ovarian cancer; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2021-003169
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: Cancer treatment-induced bone loss is a known side effect of cancer therapy. Computed tomography (CT) bone mineral density screening is a novel tool for identifying bone loss. This study aims to use routine CT images to determine long-term bone mineral density changes and osteoporosis risk among women with gynecologic cancers. Methods: Bone loss was evaluated in a retrospective cohort of women ≤65 years old with gynecologic cancer who underwent oophorectomy from January 2010 to December 2014. Opportunistic CT-based bone mineral density measurements (Hounsfield units, HU) were performed at baseline and intervals up to 5 years after cancer diagnosis. Osteoporosis risk was categorized by HU. Bivariate and multivariate analyses were performed to compare baseline to follow-up bone mineral density at 1, 3, and 5 years and to identify predictors of bone loss following diagnosis. Results: A total of 185 patients (median age 53 years, range 23–65 years, 78.1% ovarian cancer) were included. Bone mineral density significantly decreased between baseline and 1 year (p<0.001), 3 years (p<0.001), and 5 years (p<0.001). Half with normal bone mineral density at baseline had risk for osteopenia or osteoporosis at 5 years. Four percent had osteoporosis risk at baseline compared with 1 year (7.4%), 3 years (15.7%), and 5 years (18.0%). Pre-treatment bone mineral density was a significant predictor at 1 and 5 years (1 year: p<0.01; 5 years: p<0.01). History of chemotherapy predicted bone loss at 1 year (p=0.03). More lifetime chemotherapy cycles were associated with increased risk of osteoporosis at 1 year (p=0.03) and 5 years (p=0.01). Conclusions: Women with gynecologic cancers may experience accelerated cancer treatment-induced bone loss. Routine CT imaging is a convenient screening modality to identify those at highest risk for osteoporosis who warrant further evaluation with dual-energy X-ray absorptiometry. Routine bone mineral density assessments 1 year following oophorectomy for cancer treatment may be warranted in this population.