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The effects of high-dose calcitriol and individualized exercise on bone metabolism in breast cancer survivors on hormonal therapy: a phase II feasibility trial.
Peppone, Luke J; Ling, Marilyn; Huston, Alissa J; Reid, Mary E; Janelsins, Michelle C; Puzas, J Edward; Kamen, Charles; Del Giglio, Auro; Asare, Matthew; Peoples, Anita R; Mustian, Karen M.
Afiliação
  • Peppone LJ; Department of Surgery and Orthopaedics, University of Rochester Medical Center (URMC), 265 Crittenden Blvd, CU 420658, Rochester, NY, 14642, USA. luke_peppone@urmc.rochester.edu.
  • Ling M; Department of Radiation Oncology, URMC, Rochester, NY, USA.
  • Huston AJ; Department of Medicine, URMC, Rochester, NY, USA.
  • Reid ME; Roswell Park Cancer Institute, Buffalo, NY, USA.
  • Janelsins MC; Department of Surgery, URMC, Rochester, NY, USA.
  • Puzas JE; Department of Orthopaedics, URMC, Rochester, NY, USA.
  • Kamen C; Department of Surgery, URMC, Rochester, NY, USA.
  • Del Giglio A; Department of Hematology and Oncology, ABC Foundation School of Medicine, Sao Paolo, Brazil.
  • Asare M; Department of Surgery, URMC, Rochester, NY, USA.
  • Peoples AR; Department of Surgery, URMC, Rochester, NY, USA.
  • Mustian KM; Department of Surgery, URMC, Rochester, NY, USA.
Support Care Cancer ; 26(8): 2675-2683, 2018 Aug.
Article em En | MEDLINE | ID: mdl-29470705
INTRODUCTION: Cancer treatment-induced bone loss (CTIBL) is a long-term side effect of breast cancer therapy. Both calcitriol and weight-bearing exercise improve bone metabolism for osteoporotic patients, but are unproven in a breast cancer population. We used a novel high-dose calcitriol regimen with an individualized exercise intervention to improve bone metabolism in breast cancer survivors. METHODS: We accrued 41 subjects to this open label, 2 × 2 factorial, randomized feasibility trial. Breast cancer survivors were randomized to receive the following: (1) calcitriol (45 micrograms/week), (2) individualized exercise with progressive walking and resistance training, (3) both, or (4) a daily multivitamin (control condition) for 12 weeks. Primary outcomes included changes in biomarkers of bone formation, bone resorption, and the bone remodeling index, a composite measure of bone formation and resorption. Safety measures included clinical and biochemical adverse events. A main effect analysis was used for these endpoints. RESULTS: Hypercalcemia was limited to three grade I cases with no grade ≥ 2 cases. Among exercisers, 100% engaged in the prescribed aerobic training and 44.4% engaged in the prescribed resistance training. Calcitriol significantly improved bone formation (Cohen's d = 0.64; p < 0.01), resulting in a non-significant increase in the bone remodeling index (Cohen's d = 0.21; p = 31). Exercise failed to improve any of the bone biomarkers. CONCLUSIONS: Both calcitriol and exercise were shown to be feasible and well tolerated. Calcitriol significantly improved bone formation, resulting in a net increase of bone metabolism. Compliance with the exercise intervention was sub-optimal, which may have led to a lack of effect of exercise on bone metabolism.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Ósseas Metabólicas / Neoplasias da Mama / Calcitriol / Exercício Físico / Antineoplásicos Hormonais / Sobreviventes de Câncer / Hormônios e Agentes Reguladores de Cálcio Tipo de estudo: Clinical_trials Limite: Adult / Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Ósseas Metabólicas / Neoplasias da Mama / Calcitriol / Exercício Físico / Antineoplásicos Hormonais / Sobreviventes de Câncer / Hormônios e Agentes Reguladores de Cálcio Tipo de estudo: Clinical_trials Limite: Adult / Female / Humans / Middle aged Idioma: En Ano de publicação: 2018 Tipo de documento: Article