99Tc-Methylene Diphosphonate Treatment is Safe and Efficacious for Osteoporosis in Postmenopausal Differentiated Thyroid Cancer Patients Undergoing TSH Suppression: A Three-Center Non-Randomized Clinical Study

Jianhao Xie; XueYu Yuan; Weiqing Mao; Haidong Cai; Kejia Gao; Zhongwei Lv; Hui Wang; Chao Ma

doi:10.2147/CMAR.S354471

⁹⁹Tc-Methylene Diphosphonate Treatment is Safe and Efficacious for Osteoporosis in Postmenopausal Differentiated Thyroid Cancer Patients Undergoing TSH Suppression: A Three-Center Non-Randomized Clinical Study

Cancer Manag Res. 2022 Mar 5:14:995-1005. doi: 10.2147/CMAR.S354471. eCollection 2022.

Authors

Jianhao Xie^#^{1

2}, XueYu Yuan^#¹, Weiqing Mao^#¹, Haidong Cai¹, Kejia Gao³, Zhongwei Lv¹, Hui Wang⁴, Chao Ma¹

Affiliations

¹ Department of Nuclear Medicine, Tenth People's Hospital of Tongji University, Shanghai, People's Republic of China.
² Department of Orthopaedic, Beijing Jishuitan Hospital, Beijing, People's Republic of China.
³ Department of Nuclear Medicine, Shanghai No. 4 People's Hospital, Shanghai, People's Republic of China.
⁴ Department of Nuclear Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Objective: To investigate the effects of ⁹⁹Tc-methylene diphosphonate (⁹⁹Tc-MDP) on osteoporosis (OS) in postmenopausal patients with differentiated thyroid cancer (DTC) under thyroid stimulating hormone (TSH) suppression.

Patients and methods: Patients (n = 142) were divided into two groups: (1) ⁹⁹Tc-MDP (n = 70) and (2) alendronate (n = 72) treatments (NCT02304757). Bone mineral density (BMD) in the lumbar spine and hip was evaluated by DXA, along with bone turnover markers, safety, and quality of life (QOL) using SF-36 at three time points: before treatment and at 6 and/or 12 months after treatment.

Results: The percentage change of BMD in total lumbar spine or hip showed no significant difference throughout the study (P > 0.025). ⁹⁹Tc-MDP and alendronate treatment alone significantly increased BMD in the lumbar spine, but alendronate treatment also significantly increased BMD in total hip at 6 and 12 months, as compared with the baseline. There were no significant differences in the results of the SF-36 scores between the two treatment groups at any time during the whole study period. ⁹⁹Tc-MDP significantly increased bone formation markers of osteocalcin at 6 and 12 months (P all < 0.05), PINP at 12 months (P = 0.001), and bone resorption markers of β-CTX at 6 and 12 months (p < 0.05) as compared with the alendronate treated group. No adverse event was observed in the ⁹⁹Tc-MDP treatment group compared with alendronate (P = 0.014).

Conclusion: ⁹⁹Tc-MDP was as efficacious as alendronate in the improvement of lumbar BMD for DTC patients with OS under TSH stimulation. ⁹⁹Tc-MDP was shown to be safe and improved patients' QOL.

Keywords: 99Tc-MDP; differentiated thyroid cancer; osteoporosis; thyroid stimulating hormone suppression.

Publication types

Case Reports
Clinical Trial

Grants and funding

This work was supported by the National Natural Science Fund (grant numbers 82171974, 81771859, and 82071964), the Shanghai Health Bureau Fund (grant 202040085), the Clinical Research Plan of SHDC (grant number 16CR3114B), and Shanghai Shenkang Three-year Action Project (grant number: SHDC2020CR2054B).