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Identifier

000449981

Title

Μεταβολισμός των οστών σε παιδιά,εφήβους κι νεαρούς ενήλικες που έχουν ιαθεί από καρκίνο : Ανασκόπηση βιβλιογραφίας

Alternative Title

Bone metabolism in children, adolescents and young adult survivors of childhood cancer

Author

Γιαννούση, Ελισάβετ

Thesis advisor

Στειακάκη, Ευτυχία

Reviewer

Αγγελάκη, Σοφία
Ξεκούκη, Παρασκευή

Abstract

The degree of bone mass acquisition during childhood and adolescence is a well-known determinant of adulthood peak bone mass. Childhood cancer disrupts the development of the bony skeleton at a crucial stage, affecting its structure either directly or as an adverse effect of therapy. Bone mineral density and bone architecture are the main modulators of bone strength and their disturbance predispose to low impact fractures. Osteoporosis is defined as the combination of very low BMD and fractures or the presence of atraumatic vertebral fractures regardless of BMD value. The method of choice for BMD measurement in children is DEXA with the calculation of z-score and its adjustment for height. Studies that did not correct z-score for height recorded high prevalence of low and very low BMD, due to the fact that BMD is underestimated in small bones. Healthy diet with adequate calcium and vitamin D intake, daily exercise, abstention from smoking and hormonal deficiencies replacement are cornerstones of bone health preservation. High risk patients for low BMD are those treated with radiotherapy and suffering of central or peripheral hypogonadism. Genetic polymorphisms are associated with diverse effects of glucocorticoids and chemotherapeutic agents and are plausible stratification and therapeutic targets. Screening with DEXA is recommended to high- risk patients at entry into long-term follow-up and repeated at 25 years of age, unless clinical signs or abnormal findings indicate closer surveillance. Patients with diagnosis of osteoporosis are better referred to a bone health specialist and are candidates for bone resorption inhibitors treatment.

Language

Greek

Subject

Bisphosphonates

Bone health

Bone mineral density

Chemotherapy

Glucocorticoids

Radiation therapy

Ακτινοθεραπεία

Γλυκοκορτικοειδή

Διφωσφονικά