Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis.
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| Title: | Bone Mineral Density in Survivors of Childhood Cancer: A Meta-Analysis. |
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| Authors: | Velentza, Lilly, Filis, Panagiotis, Wilhelmsson, Mari, Kogner, Per, Herold, Nikolas, Sävendahl, Lars |
| Source: | Pediatrics. Aug2024, Vol. 154 Issue 2, p1-15. 15p. |
| Subjects: | Risk assessment, Drug toxicity, Medical information storage & retrieval systems, Photon absorptiometry, Public health surveillance, Tumors in children, Bone density, Research funding, Femoral fractures, Hip fractures, Antineoplastic agents, Cancer patients, Meta-analysis, Descriptive statistics, Vertebral fractures, Bone fractures, Systematic reviews, MEDLINE, Medical databases, Osteoporosis, Confidence intervals, Disease risk factors, Children |
| Abstract: | CONTEXT: There is an increasing population of childhood cancer survivors (CCS) at risk for treatment-related toxicities, including skeletal morbidities. Bone mineral density (BMD) is a proxy for bone health and reductions are associated with osteoporosis and fractures. OBJECTIVE: To investigate bone health in CCS by conducting a systematic review and meta-analysis of BMD after completed treatments. DATA SOURCES: We searched Medline, Embase, Cochrane, and Web of Science in May 2019 and updated in May 2023. STUDY SELECTION: Studies reporting BMD Z-scores measured with dual-energy x-ray absorptiometry in CCS after treatment completion. DATA EXTRACTION: We performed a pooled analysis of studies reporting BMD Z-scores and thereafter we analyzed studies comparing BMD in survivors and healthy controls. All analyses were performed based on the site of BMD measurement. RESULTS: Of 4243 studies, 84 were included (N = 8106). The mean time off-treatment across the studies ranged from 2 months to 24 years. The overall pooled mean Z-score was -0.57 (95% confidence interval [CI] -0.59 to -0.55) in the whole-body, -0.84 (95% CI -0.86 to -0.83) in the lumbar spine, -0.79 (95% CI -0.81 to -0.77) in the femoral neck and -0.14 (95% CI -0.18 to -0.11) in the total hip. When comparing survivors with controls, BMD was significantly lower in survivors at all sites. LIMITATIONS: English publications, study-level meta-analysis. CONCLUSIONS: We showed a significant reduction of BMD Z-scores in CCS. Given the increased fracture risk already within -1 SD, these results emphasize the need for BMD surveillance and secondary prevention in CCS. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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