Osteoporose bei Krebserkrankungen

Zusammenfassung

Patienten mit Krebserkrankungen haben ein deutlich erhöhtes Risiko für eine Osteoporose. Epidemiologische Daten hierzu sind vor allem für Deutschland recht knapp. Grund der Osteoporose ist neben direkten knochentoxischen Effekten von Tumorzytokinen und Chemotherapeutika meist ein therapieinduzierter Hypogonadismus, weshalb vorwiegend Patienten mit Mamma- und Prostatakarzinom betroffen sind. Bei anderen Tumorarten spielen unter anderem steroidhaltige Behandlungsregimes eine ätiologische Rolle. Therapeutisch kommen neben Basismaßnahmen wie einer „knochengesunden Lebensweise“ und der Gabe von Kalzium und Vitamin D vor allem Bisphosphonate zum Einsatz. Auch für den monoklonalen Antikörper Denosumab, einen RANKL-Inhibitor, liegen erste positive Ergebnisse vor.

Summary

In cancer patients, the risk for osteoporosis is increased considerably. Epidemiological data concerning that topic are scarce, especially in Germany. Besides direct bone-toxic effects of tumor-cytokines and chemotherapy, the source of osteoporosis mostly is a hypogonadism induced by therapy. Therefore, mainly patients with breast and prostatic cancer may develop osteoporosis. In other types of cancer, therapy regimens containing steroids play an etiological role. Besides basic measures like a bone-healthy lifestyle and substitution of calcium and cholecalciferol, bisphosphonates are mainly used for treatment. Denosumab, a monoclonal antibody and inhibitor of RANKL, demonstrated first positive results in several trials.

Schlüsselwörter

Osteoporose - Krebs - Hypogonadismus

Keywords

Osteoporosis - cancer - hypogonadism

• Literatur

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