PREDICTORS OF BONE-MINERAL LOSS IN PATIENTS WITH OVARIAN-CANCER TREATED WITH ANTICANCER AGENTS

Objective: To identify factors predicting bone mineral loss during ant icancer chemotherapy. Methods: Fifteen women (mean age 38.2 +/- 7.8 ye ars; range 30-46 years) with ovarian cancer who had been treated with cisplatin-adriamycin-cyclophosphamide for six cycles every 4 weeks fol lowing surgical cytoreduction were studied. Bone mineral density (BMD) of the lumbar spine (L2-L4) was measured by dual-energy x-ray absorpt iometry before and after chemotherapy. Fifteen age-matched women whose ovaries had been removed surgically for other reasons served as contr ols. None of the patients had received hormonal treatment. The two gro ups were compared for percentage change of BMD (BMD%) over the same pe riod. In the chemotherapy group, total fat mass, body fat ratio, total lean mass, percent lean, and ratio of trunk fat to leg fat were measu red by dual-energy x-ray absorptiometry. Lean loss during chemotherapy was also calculated. These variables were compared before and at the end of chemotherapy. Possible correlations of baseline variables with BMD% were determined in univariate and stepwise regression analysis. R esults: Mean (+/- standard deviation) BMD decreased to 87.4 +/- 2.1% a fter six cycles of chemotherapy and 97.6 +/- 0.4% after 6 months in co ntrols, but the greatest decrease was observed in the chemotherapy gro up (P < .001). Although baseline lean mass, baseline BMD, body weight, and lean loss during chemotherapy were correlated with BMD% in univar iate analysis, baseline lean mass was still significant in stepwise re gression analysis. Conclusion: Baseline lean mass predicts bone minera l loss with anticancer chemotherapy. (C) 1997 by The American College of Obstetricians and Gynecologists.