3D-EBRT for Prostate Cancer May Increase Risk of Hip Fracture

SAN FRANCISCO—Prostate cancer patients undergoing three-dimensional external beam radiation therapy (3DEBRT) for prostate cancer may be at an increased risk of hip fracture and could benefit from additional measures to improve bone health following treatment, according to a study by Minneapolis researchers. They presented new data at the 2010 annual meeting of the American Urological Association (AUA) suggesting that prostate cancer patients treated with 3D-EBRT may be at significantly more risk of fracture than previously recognized.

EBRT has been shown to increase hip fracture risk in women but little is known regarding how significantly EBRT impacts a man’s risk. Until now, studies have not looked at whether EBRT’s impact on a man’s risk for fracture extends beyond the radiation field.

Shaheen Alanee, MD, a medical resident in urologic surgery at the University of Minnesota, Minneapolis, and colleagues identified 166,162 prostate cancer patients, aged 66 years and older, in the Surveillance, Epidemiology, and End Results database.

The investigators compared hip fracture risk (inside the radiation field) with wrist fracture risk (outside the radiation field) in men who had undergone 3D-EBRT and those who had not. After controlling for those who were undergoing androgen suppression therapy (AST), which weakens bones, as well as other risk factors, including osteoporosis, race, and age, the researchers determined that undergoing 3D-EBRT increased a man’s risk of hip fracture by 58%, without increasing the risk of wrist fracture.

Patients being treated with AST had an increased risk of both types of break.

“Maintaining bone health is an important part of treating prostate cancer patients, particularly those on AST,” said urologist Jeff Holzbeierlein, MD, who is an AUA spokesman. “These data suggest that we might consider taking similar measures with our patients who are receiving three-dimensional external beam radiation therapy.”