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Management Manual for Cancer Treatment-Induced Bone Loss (CTIBL): Position Statement of the JSBMR

Seiji Fukumoto 1, Satoshi Soen 2, Tetsuya Taguchi 3, Takashi Ishikawa 4, Hisashi Matsushima 5, Masakazu Terauchi 6, Shigeo Horie 7, Toshiyuki Yoneda 8, Toshitsugu Sugimoto 9, Toshio Matsumoto 10, Subcommittee for CTIBL in the JSBMR

DOI: 10.1007/s00774-020-01087-0

Abstract
Androgen deprivation therapy and aromatase inhibitors are known to cause a decrease in bone mineral density and an increase in fractures. Patients receiving these treatments have been shown to have a fracture risk equal to or greater than that of patients with osteoporosis with prevalent fractures. This manual was created to prevent fractures in patients with cancer treatment-induced bone loss with high fracture risks who cannot be treated under the current Japanese guideline for the prevention and treatment of osteoporosis. This manual recommends drug treatment for patients with BMD – 2.0 ≤ T score < - 1.5 with the family history of hip fracture or 15% or more 10-year probability of major osteoporotic fractures by FRAX®; or in patients with BMD T score < - 2.0. It is important to verify whether the use of this manual can reduce fractures and improve the quality of life of patients with cancer treatment-induced bone loss by prospective studies.