{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T02:12:35Z","timestamp":1788833555774,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,11]],"date-time":"2014-02-11T00:00:00Z","timestamp":1392076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            To study the influence of adjuvant androgen suppression and bisphosphonates on incident vertebral and non\u2010spinal fracture rates and bone mineral density (\n                            <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>\n                            ) in men with locally advanced prostate cancer.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            Between 2003 and 2007, 1071 men with locally advanced prostate cancer were randomly allocated, using a 2 \u00d7 2 trial design, to 6 months i.m. leuprorelin (androgen suppression [\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            ]) before radiotherapy alone \u00b1 12 months additional leuprorelin \u00b1 18 months zoledronic acid (\n                            <jats:styled-content style=\"fixed-case\">ZdA<\/jats:styled-content>\n                            ), commencing at randomization.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The main endpoint was incident thoraco\u2010lumbar vertebral fractures, which were assessed radiographically at randomization and at 3 years, then reassessed by centralized review.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Subsidiary endpoints included incident non\u2010spinal fractures, which were documented throughout follow\u2010up, and\n                            <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>\n                            , which was measured in 222 subjects at baseline, 2 years and 4 years.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            Incident vertebral fractures at 3 years were observed in 132 subjects. Their occurrence was not increased by 18 months\u2019\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            , nor reduced by\n                            <jats:styled-content style=\"fixed-case\">ZdA<\/jats:styled-content>\n                            .\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Incident non\u2010spinal fractures occurred in 72 subjects and were significantly related to\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            duration but not to\n                            <jats:styled-content style=\"fixed-case\">ZdA<\/jats:styled-content>\n                            .\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Osteopenia and osteoporosis prevalence rates at baseline were 23.4 and 1.4%, respectively, at the hip.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            Treatment for 6 and 18 months with\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            caused significant reductions in hip\n                            <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>\n                            at 2 and 4 years (\n                            <jats:italic>P<\/jats:italic>\n                            &lt; 0.01) and\n                            <jats:styled-content style=\"fixed-case\">ZdA<\/jats:styled-content>\n                            prevented these losses at both time points.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            In an\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            \u2010na\u00efve population, 18 months of\n                            <jats:styled-content style=\"fixed-case\">ZdA<\/jats:styled-content>\n                            treatment prevented the sustained\n                            <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>\n                            losses caused by 18 months of\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            treatment; however, the study power was insufficient to show that\n                            <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>\n                            duration or\n                            <jats:styled-content style=\"fixed-case\">ZdA<\/jats:styled-content>\n                            influenced vertebral fracture rates.\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.12497","type":"journal-article","created":{"date-parts":[[2013,10,15]],"date-time":"2013-10-15T12:08:33Z","timestamp":1381838913000},"page":"344-353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Impact of androgen suppression and zoledronic acid on bone mineral density and fractures in the Trans\u2010Tasman Radiation Oncology Group (\n                    <scp>TROG<\/scp>\n                    ) 03.04 Randomised Androgen Deprivation and Radiotherapy (\n                    <scp>RADAR<\/scp>\n                    ) randomized controlled trial for locally advanced prostate cancer"],"prefix":"10.1111","volume":"114","author":[{"given":"James W.","family":"Denham","sequence":"first","affiliation":[{"name":"School of Medicine and Public Health, University of Newcastle, Radiation Oncology Department, Calvary Mater Newcastle  NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Nowitz","sequence":"additional","affiliation":[{"name":"Pacific Radiology  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Joseph","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Western Australia, School of Human Movement, Edith Cowan University, Sir Charles Gairdner Hospital  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Duchesne","sequence":"additional","affiliation":[{"name":"Peter MacCallum Cancer Centre  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel A.","family":"Spry","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Western Australia, School of Human Movement, Edith Cowan University, Sir Charles Gairdner Hospital  Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Lamb","sequence":"additional","affiliation":[{"name":"Wellington Cancer Centre  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Matthews","sequence":"additional","affiliation":[{"name":"Auckland Hospital  Auckland New 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