Impact of androgen suppression and zoledronic acid on bone mineral density and fractures in the Trans-Tasman Radiation Oncology Group (TROG) 03.04 Randomised Androgen Deprivation and Radiotherapy (RADAR) randomized controlled trial for locally advanced pr

Denham, James W., Nowitz, Michael, Joseph, David, Duchesne, Gillian, Spry, Nigel A., Lamb, David S., Matthews, John, Turner, Sandra, Atkinson, Chris, Tai, Keen-Hun, Gogna, Nirdosh Kumar, Kenny, Lizbeth, Diamond, Terry, Smart, Richard, Rowan, David, Moscato, Pablo, Vimieiro, Renato, Woodfield, Richard, Lynch, Kevin, Delahunt, Brett, Murray, Judy, D'Este, Cate, McElduff, Patrick, Steigler, Allison, Kautto, Allison and Ball, Jean (2014) Impact of androgen suppression and zoledronic acid on bone mineral density and fractures in the Trans-Tasman Radiation Oncology Group (TROG) 03.04 Randomised Androgen Deprivation and Radiotherapy (RADAR) randomized controlled trial for locally advanced prostate cancer. BJU International, 114 3: 344-353. doi:10.1111/bju.12497

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Author Denham, James W.
Nowitz, Michael
Joseph, David
Duchesne, Gillian
Spry, Nigel A.
Lamb, David S.
Matthews, John
Turner, Sandra
Atkinson, Chris
Tai, Keen-Hun
Gogna, Nirdosh Kumar
Kenny, Lizbeth
Diamond, Terry
Smart, Richard
Rowan, David
Moscato, Pablo
Vimieiro, Renato
Woodfield, Richard
Lynch, Kevin
Delahunt, Brett
Murray, Judy
D'Este, Cate
McElduff, Patrick
Steigler, Allison
Kautto, Allison
Ball, Jean
Title Impact of androgen suppression and zoledronic acid on bone mineral density and fractures in the Trans-Tasman Radiation Oncology Group (TROG) 03.04 Randomised Androgen Deprivation and Radiotherapy (RADAR) randomized controlled trial for locally advanced prostate cancer
Journal name BJU International   Check publisher's open access policy
ISSN 1464-4096
1464-410X
Publication date 2014-09
Year available 2014
Sub-type Article (original research)
DOI 10.1111/bju.12497
Open Access Status
Volume 114
Issue 3
Start page 344
End page 353
Total pages 10
Place of publication Chichester, West Sussex, England
Publisher Wiley-Blackwell Publishing
Collection year 2015
Language eng
Subject 2748 Urology
Formatted abstract
Objective: To study the influence of adjuvant androgen suppression and bisphosphonates on incident vertebral and non-spinal fracture rates and bone mineral density (BMD) in men with locally advanced prostate cancer.

Patients and Methods: Between 2003 and 2007, 1071 men with locally advanced prostate cancer were randomly allocated, using a 2 × 2 trial design, to 6 months i.m. leuprorelin (androgen suppression [AS]) before radiotherapy alone ± 12 months additional leuprorelin ± 18 months zoledronic acid (ZdA), commencing at randomization. The main endpoint was incident thoraco-lumbar vertebral fractures, which were assessed radiographically at randomization and at 3 years, then reassessed by centralized review. Subsidiary endpoints included incident non-spinal fractures, which were documented throughout follow-up, and BMD, which was measured in 222 subjects at baseline, 2 years and 4 years.

Results: Incident vertebral fractures at 3 years were observed in 132 subjects. Their occurrence was not increased by 18 months' AS, nor reduced by ZdA. Incident non-spinal fractures occurred in 72 subjects and were significantly related to AS duration but not to ZdA. Osteopenia and osteoporosis prevalence rates at baseline were 23.4 and 1.4%, respectively, at the hip. Treatment for 6 and 18 months with AS caused significant reductions in hip BMD at 2 and 4 years (P < 0.01) and ZdA prevented these losses at both time points.

Conclusion: In an AS-naïve population, 18 months of ZdA treatment prevented the sustained BMD losses caused by 18 months of AS treatment; however, the study power was insufficient to show that AS duration or ZdA influenced vertebral fracture rates.
Keyword Prostate cancer
Androgen suppression
Fractures
Bone mineral density
Bisphophonate
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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