BONE-FRACTURES ASSOCIATED WITH LUTEINIZING-HORMONE-RELEASING HORMONE AGONISTS USED IN THE TREATMENT OF PROSTATE CARCINOMA

BACKGROUND, Luteinizing hormone-releasing hormone agonists (LHRH-a) ha ve become an established treatment for certain patients with prostate carcinoma. LHRH-a are known to decrease bone mineral density. The purp ose of this study was to determine the risk of bone fracture in men re ceiving LHRH-a for prostate carcinoma. METHODS, A retrospective chart review and phone interviews were conducted to determine the incidence of bone fractures occurring in patients receiving LHRH-a for the treat ment of prostate carcinoma. Abstracted data included the number of mon thly LHRH-a injections, age, clinical stage of disease, sites of metas tases, and bone fracture history. RESULTS, Twenty of the 224 patients (9%) treated with LHRH-a for prostate carcinoma between 1988 and 1995 at 3 teaching hospitals had at least 1 bone fracture during treatment with LHRH-a. The duration of treatment to the time of fracture ranged from 1 to 96 months (mean, 22.2 months). Seven fractures (32%) were os teoporotic in nature (i.e., vertebral compression fractures or hip fra ctures after a fall from standing), whereas 8 fractures (36%) were ass ociated with a significant traumatic event (i.e., a motor vehicle acci dent, boxing, etc.) and 5 were of mixed etiology. Two of 22 fractures (9%) were pathologic. CONCLUSIONS, This study demonstrated a 9% fractu re incidence in a cohort of patients receiving LHRH-a for prostate car cinoma for up to 96 months. The incidence of osteoporotic fractures wa s 5%. (C) 1997 American Cancer Society.