Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study
Abstract Bone changes in patients undergoing pelvic radiotherapy remain unclear. This study initially utilized high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess the dynamic changes in bone microarchitecture and volumetric bone mineral density (BMD) in patients with cerv...
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2025-03-01
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| Online Access: | https://doi.org/10.1186/s40364-025-00754-6 |
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| author | Weishi Cheng Yijun Wu Jing Shen Hui Guan Li Zhang Hongnan Zhen Yinjie Tao Weibo Xia Zhikai Liu Fuquan Zhang |
| author_facet | Weishi Cheng Yijun Wu Jing Shen Hui Guan Li Zhang Hongnan Zhen Yinjie Tao Weibo Xia Zhikai Liu Fuquan Zhang |
| author_sort | Weishi Cheng |
| collection | DOAJ |
| description | Abstract Bone changes in patients undergoing pelvic radiotherapy remain unclear. This study initially utilized high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess the dynamic changes in bone microarchitecture and volumetric bone mineral density (BMD) in patients with cervical cancer before and after concurrent chemoradiotherapy. This prospective, observational study included patients with squamous carcinoma of the cervix scheduled for concurrent chemoradiotherapy. Patients underwent HR-pQCT, dual-energy X-ray absorptiometry (DXA) and laboratory tests before chemoradiotherapy, and at three and six months post-chemoradiotherapy. DXA, serving as the clinical standard for measuring BMD, was employed alongside HR-pQCT to provide complementary insights into bone micro-changes. The primary endpoint comprised changes in total (Tt.vBMD), trabecular (Tb.vBMD) and cortical (Ct.vBMD) volumetric BMD at the distal radius and tibia between pre-chemoradiotherapy and 6 months post-chemoradiotherapy. A total of 21 patients were enrolled, and one patient chose to withdraw (median age: 54.5 years). Tt.vBMD significantly decreased three months (distal radius: -1.65%, P = 0.008; distal tibia: -2.4%, P < 0.001) and six months (distal radius: -3.03%, P = 0.003; distal tibia: -2.69%, P = 0.002) post-chemoradiotherapy compared to baseline. Similarly, Tb.vBMD and Ct.vBMD demonstrated a significant downward trend post-chemoradiotherapy, with mean percent changes at three months of -0.73% and − 1.59% for the distal radius, and − 1.95% and − 1.50% for the distal tibia, respectively. The trends in BMD changes measured by DXA align with those observed using HR-pQCT. Regarding the laboratory tests, estradiol levels significantly decreased post-chemoradiotherapy, while follicle stimulating hormone and luteinizing hormone levels significantly increased. The results found that concurrent chemoradiotherapy was associated with the changes in bone volume, microstructure and BMD, especially in BMD three months post-chemoradiotherapy. Most of the bone micro-changes had not reverted by six months. This study explored the feasibility of early fracture risk identification post-chemoradiotherapy, aiding physicians in taking timely measures to improve prognosis. |
| format | Article |
| id | doaj-art-d529b233b6b44ab7bd946164ddbdafd3 |
| institution | DOAJ |
| issn | 2050-7771 |
| language | English |
| publishDate | 2025-03-01 |
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| series | Biomarker Research |
| spelling | doaj-art-d529b233b6b44ab7bd946164ddbdafd32025-08-20T02:52:19ZengBMCBiomarker Research2050-77712025-03-011311610.1186/s40364-025-00754-6Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective studyWeishi Cheng0Yijun Wu1Jing Shen2Hui Guan3Li Zhang4Hongnan Zhen5Yinjie Tao6Weibo Xia7Zhikai Liu8Fuquan Zhang9Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Hematology, West China Hospital, Sichuan UniversityDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeKey Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Bone changes in patients undergoing pelvic radiotherapy remain unclear. This study initially utilized high-resolution peripheral quantitative computed tomography (HR-pQCT) to assess the dynamic changes in bone microarchitecture and volumetric bone mineral density (BMD) in patients with cervical cancer before and after concurrent chemoradiotherapy. This prospective, observational study included patients with squamous carcinoma of the cervix scheduled for concurrent chemoradiotherapy. Patients underwent HR-pQCT, dual-energy X-ray absorptiometry (DXA) and laboratory tests before chemoradiotherapy, and at three and six months post-chemoradiotherapy. DXA, serving as the clinical standard for measuring BMD, was employed alongside HR-pQCT to provide complementary insights into bone micro-changes. The primary endpoint comprised changes in total (Tt.vBMD), trabecular (Tb.vBMD) and cortical (Ct.vBMD) volumetric BMD at the distal radius and tibia between pre-chemoradiotherapy and 6 months post-chemoradiotherapy. A total of 21 patients were enrolled, and one patient chose to withdraw (median age: 54.5 years). Tt.vBMD significantly decreased three months (distal radius: -1.65%, P = 0.008; distal tibia: -2.4%, P < 0.001) and six months (distal radius: -3.03%, P = 0.003; distal tibia: -2.69%, P = 0.002) post-chemoradiotherapy compared to baseline. Similarly, Tb.vBMD and Ct.vBMD demonstrated a significant downward trend post-chemoradiotherapy, with mean percent changes at three months of -0.73% and − 1.59% for the distal radius, and − 1.95% and − 1.50% for the distal tibia, respectively. The trends in BMD changes measured by DXA align with those observed using HR-pQCT. Regarding the laboratory tests, estradiol levels significantly decreased post-chemoradiotherapy, while follicle stimulating hormone and luteinizing hormone levels significantly increased. The results found that concurrent chemoradiotherapy was associated with the changes in bone volume, microstructure and BMD, especially in BMD three months post-chemoradiotherapy. Most of the bone micro-changes had not reverted by six months. This study explored the feasibility of early fracture risk identification post-chemoradiotherapy, aiding physicians in taking timely measures to improve prognosis.https://doi.org/10.1186/s40364-025-00754-6High-resolution peripheral quantitative computed tomographyCervical cancerBone mineral densityBone microstructureChemoradiotherapy |
| spellingShingle | Weishi Cheng Yijun Wu Jing Shen Hui Guan Li Zhang Hongnan Zhen Yinjie Tao Weibo Xia Zhikai Liu Fuquan Zhang Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study Biomarker Research High-resolution peripheral quantitative computed tomography Cervical cancer Bone mineral density Bone microstructure Chemoradiotherapy |
| title | Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study |
| title_full | Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study |
| title_fullStr | Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study |
| title_full_unstemmed | Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study |
| title_short | Dynamic changes of bone microarchitecture and volumetric mineral density assessed by HR-pQCT in patients with cervical cancer after concurrent chemoradiotherapy: a prospective study |
| title_sort | dynamic changes of bone microarchitecture and volumetric mineral density assessed by hr pqct in patients with cervical cancer after concurrent chemoradiotherapy a prospective study |
| topic | High-resolution peripheral quantitative computed tomography Cervical cancer Bone mineral density Bone microstructure Chemoradiotherapy |
| url | https://doi.org/10.1186/s40364-025-00754-6 |
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