| Objective:To explore the effect of two different chemotherapy regimens on CT bone mass of thoracic vertebra in lung cancer patients and the possible factors affecting bone density.Methods:A retrospective study was conducted on 119 patients with pathologically diagnosed lung cancer admitted to the Guangxi Medical University Affiliated Tumor Hospital on October 1,2013 and October 1,2019.These cases were divided into two groups according to different clinical chemotherapy regimens:Group A（n=70）received pemetrexed+platinum chemotherapy,Group B（n=49）was treated with etoposide+platinum regimen.Every 21 days is a chemotherapy cycle.Target thoracic vertebral body bone CT value were measured before（T0）,treatment 2 cycles of chemotherapy（T2）,treatment after four cycles of chemotherapy（T4）,treatment after six cycles of chemotherapy（T6）after a total of four time points（T0,T2,T4 and T6）,compared two groups of target thoracic vertebral body bone CT value changes,to explore the influence target thoracic vertebral body bone CT value changing factors.And analysis of each point（T0,T2,T4 and T6）target thoracic vertebral body bone CT values and the corresponding chemotherapy drugs,dexamethasone,bisphosphonates,recombinant human granulocyte colony stimulating factor（G-CSF）,correlation analysis was conducted between T2 target thoracic vertebra bone CT value and the cumulative dose of the above-mentioned drugs in 2cycles,correlation analysis was conducted between T4 target thoracic vertebra bone CT value and the cumulative dose of the above-mentioned drugs in 4cycles,correlation analysis was conducted between the CT value of the T6 target thoracic vertebra and the cumulative dose of the above mentioned drugs in 6cycles.Results:1.Comparison between pemetrexed group and etoposide group:（1）Bone mineral density decreased in both groups after chemotherapy,and the longer the chemotherapy period was,the more significant the decrease was.（2）There was no statistically significant difference between the two groups,and no difference in bone mineral density between the two groups.2.（1）Univariate analysis showed that age and menopause were the influencing factors of BMD in the Pemetrec group.For the etoposide group,age,menopause,CEA level,and zoledronic acid use were the influencing factors.（2）According to the multi-factor analysis,age,menopause,stage and G-CSF use are the factors affecting bone mineral density.3.Correlation analysis:（1）There was no correlation between the target thoracic vertebra bone CT value of T2,T4 and T6 in the Permetroxel group and the corresponding cumulative dose of drugs.（2）The CT values of the target thoracic vertebra in the etoposide group T2,T4 and T6 were moderately correlated with the cumulative dose of corresponding zoledronic acid,and the degree of correlation increased over time.（3）The CT value of the T6target thoracic vertebra in the etoposide group was moderately correlated with the cumulative dose of etoposide 6 cycle.4.（1）T0 regression analysis:Multiple linear regressions were used to predict bone mineral density based on age,menopause,gender,CEA,stage,and group.The T0 regression equation can be expressed as:Formula1:Y(T0BMD)=199.075-21.032X1（age）-50.536X2（menopause）+64.309X3（gender）-8.029X4（CEA）+13.353X5（stage）-2.566X6（group）（2）T2 regression analysis:Multiple linear regression was used to predict bone density based on age,menopause,gender,CEA,stage,group,G-CSF use,and Zoledronic acid use.The T2 regression equation is expressed as:Formula2:Y(T2 BMD)=197.407-22.123X1（age）-51.435X2（menopause）+55.665X3（gender）-4.579X4（CEA）+19.328X5（stage）+1.369X6（group）-6.761X7（G-CSF）-1.360X8（Zoledronic acid）（3）T4 regression analysis:Multiple linear regression was used to predict bone density based on age,menopause,gender,CEA,stage,group,G-CSF use,and Zoledronic acid use.The T4 regression equation is expressed as:Formula3:Y(T4BMD)=171.952-21.615X1（age）-47.107X2（menopause）+55.856X3（gender）-8.830X4（CEA）+15.084X5（stage）+2.292X6（group）+9.874X7（G-CSF）+9.665X8（Zoledronic）acid（4）T6 regression analysis:Multiple linear regression was used to predict bone density based on age,menopause,gender,CEA,stage,group,G-CSF use,and Zoledronic acid use.The T6 regression equation is expressed as:Formula4:Y（T6） BMD</sub>=186.907-27.168X1（age）-45.142X2（menopause）+51.565X3（gender）-7.410X4（CEA）+12.498X5（stage）+0.639X6（group）-9.858X7（G-CSF）+15.468X8（Zoledronic acid）Conclusion:1.In lung cancer patients undergoing 6 cycles of chemotherapy,bone mineral density showed a downward trend after chemotherapy,and the longer the treatment period was,the more significant the decline was.There was no difference in bone mineral density between the two chemotherapy regimens.2.Age and menopause were independent factors affecting bone mineral density.Initial CEA level,tumor stage,zoledronic acid use,and G-CSF use were potential factors affecting bone density.3.For the etoposide group,bone mineral density was moderately correlated with the cumulative dose of zoledronic acid,and the degree of correlation increased over time.4.There is a linear relationship between BMD and age,menopause and gender in patients undergoing chemotherapy for lung cancer.BMD can be predicted by age,menopause and gender. |
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