Literature DB >> 20052724

Pelvic fractures after radiotherapy for cervical cancer: implications for survivors.

Kathleen M Schmeler1, Anuja Jhingran, Revathy B Iyer, Charlotte C Sun, Patricia J Eifel, Pamela T Soliman, Pedro T Ramirez, Michael Frumovitz, Diane C Bodurka, Anil K Sood.   

Abstract

BACKGROUND: The incidence of pelvic fractures and associated risk factors was determined in women treated with curative-intent radiotherapy for cervical cancer.
METHODS: The records of 516 women treated with curative-intent radiotherapy for cervical cancer between 2001 and 2006 at the University of Texas M. D. Anderson Cancer Center were reviewed. Among these, 300 patients had at least 1 post-treatment computed tomography scan or magnetic resonance imaging study available for review, and they comprised our study population. All imaging studies were re-reviewed by a single radiologist to evaluate for fractures.
RESULTS: Pelvic fractures were noted in 29 of 300 patients (9.7%). Fracture sites included sacrum (n = 24; 83%), sacrum and pubis (n = 3; 10%), iliac crest (n = 1; 3%), and sacrum and acetabulum (n = 1; 3%). Thirteen patients (45%) were symptomatic, with pain being the most common presenting symptom. The median time from the completion of radiotherapy to the detection of fractures on imaging studies was 14.1 months (range, 2.1-63.1 months), with 38% of patients diagnosed within 1 year and 83% diagnosed within 2 years of completing therapy. The median age of the patients at diagnosis was higher in the women who developed a fracture compared with the women who did not (56.5 years vs 46.7 years; P = .04). A higher number of women with a fracture were postmenopausal (62% vs 37%; P = .03). The median body mass index was lower in the women who had a fracture (26.0 kg/m2 vs 28.0 kg/m2; P = .03).
CONCLUSIONS: Pelvic fractures were detected in a substantial proportion of women after radiotherapy for cervical cancer. Bone mineral density screening and pharmacologic intervention should be considered in these women. Copyright 2009 American Cancer Society.

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Year:  2010        PMID: 20052724      PMCID: PMC5084848          DOI: 10.1002/cncr.24811

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  19 in total

1.  Risk of pelvic fractures in older women following pelvic irradiation.

Authors:  Nancy N Baxter; Elizabeth B Habermann; Joel E Tepper; Sara B Durham; Beth A Virnig
Journal:  JAMA       Date:  2005-11-23       Impact factor: 56.272

2.  Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer.

Authors:  M Morris; P J Eifel; J Lu; P W Grigsby; C Levenback; R E Stevens; M Rotman; D M Gershenson; D G Mutch
Journal:  N Engl J Med       Date:  1999-04-15       Impact factor: 91.245

3.  Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer.

Authors:  P G Rose; B N Bundy; E B Watkins; J T Thigpen; G Deppe; M A Maiman; D L Clarke-Pearson; S Insalaco
Journal:  N Engl J Med       Date:  1999-04-15       Impact factor: 91.245

4.  Pelvic insufficiency fractures in patients with pelvic irradiation.

Authors:  A Moreno; J Clemente; C Crespo; A Martínez; M Navarro; L Fernández; J Minguell; G Vázquez; F J Andreu
Journal:  Int J Radiat Oncol Biol Phys       Date:  1999-04-01       Impact factor: 7.038

5.  Fractures between the ages of 20 and 50 years increase women's risk of subsequent fractures.

Authors:  Fiona Wu; Barbara Mason; Anne Horne; Ruth Ames; Judith Clearwater; Michael Liu; Margaret C Evans; Gregory D Gamble; Ian R Reid
Journal:  Arch Intern Med       Date:  2002-01-14

6.  Carcinoma of the cervix treated with radiation therapy. I. A multi-variate analysis of prognostic variables in the Gynecologic Oncology Group.

Authors:  F B Stehman; B N Bundy; P J DiSaia; H M Keys; J E Larson; W C Fowler
Journal:  Cancer       Date:  1991-06-01       Impact factor: 6.860

7.  Incidence of radiation-induced insufficiency fractures of the female pelvis: evaluation with MR imaging.

Authors:  V Blomlie; E K Rofstad; K Talle; K Sundfør; M Winderen; H H Lien
Journal:  AJR Am J Roentgenol       Date:  1996-11       Impact factor: 3.959

8.  The association between body mass index and osteoporosis in patients referred for a bone mineral density examination.

Authors:  Kofi Asomaning; Elizabeth R Bertone-Johnson; Philip C Nasca; Frederick Hooven; Penelope S Pekow
Journal:  J Womens Health (Larchmt)       Date:  2006-11       Impact factor: 2.681

9.  Prophylactic extended-field irradiation of para-aortic lymph nodes in stages IIB and bulky IB and IIA cervical carcinomas. Ten-year treatment results of RTOG 79-20.

Authors:  M Rotman; T F Pajak; K Choi; M Clery; V Marcial; P W Grigsby; J Cooper; M John
Journal:  JAMA       Date:  1995-08-02       Impact factor: 56.272

10.  Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma.

Authors:  H M Keys; B N Bundy; F B Stehman; L I Muderspach; W E Chafe; C L Suggs; J L Walker; D Gersell
Journal:  N Engl J Med       Date:  1999-04-15       Impact factor: 91.245

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  32 in total

1.  Percutaneous osteosynthesis in the pelvis in cancer patients.

Authors:  Frederic Deschamps; Thierry de Baere; Antoine Hakime; Ernesto Pearson; Geoffroy Farouil; Christophe Teriitehau; Lambros Tselikas
Journal:  Eur Radiol       Date:  2015-08-30       Impact factor: 5.315

2.  Needle-free cervical cancer treatment using helical multishield intracavitary rotating shield brachytherapy with the 169 Yb Isotope.

Authors:  Karolyn M Hopfensperger; Quentin Adams; Yusung Kim; Xiaodong Wu; Weiyu Xu; Kaustubh Patwardhan; Bounnak Thammavong; Joseph Caster; Ryan T Flynn
Journal:  Med Phys       Date:  2020-03-13       Impact factor: 4.071

3.  Effects of ex vivo ionizing radiation on collagen structure and whole-bone mechanical properties of mouse vertebrae.

Authors:  Megan M Pendleton; Shannon R Emerzian; Jennifer Liu; Simon Y Tang; Grace D O'Connell; Joshua S Alwood; Tony M Keaveny
Journal:  Bone       Date:  2019-08-21       Impact factor: 4.398

Review 4.  Pelvic insufficiency fracture (PIF) incidence in patients treated with intensity-modulated radiation therapy (IMRT) for gynaecological or anal cancer: single-institution experience and review of the literature.

Authors:  Louis Bazire; Haoping Xu; Jean-Philippe Foy; Malika Amessis; Caroline Malhaire; Kim Cao; Anne De La Rochefordiere; Youlia M Kirova
Journal:  Br J Radiol       Date:  2017-03-14       Impact factor: 3.039

5.  Severe late toxicities following concomitant chemoradiotherapy compared to radiotherapy alone in cervical cancer: an inter-era analysis.

Authors:  Vinai Gondi; Søren M Bentzen; Kathryn L Sklenar; Emily F Dunn; Daniel G Petereit; Scott P Tannehill; Margaret Straub; Kristin A Bradley
Journal:  Int J Radiat Oncol Biol Phys       Date:  2012-08-14       Impact factor: 7.038

6.  Effects of zoledronate on the radiation-induced collagen breakdown: a prospective randomized clinical trial.

Authors:  M Gierloff; M Reutemann; A Gülses; P Niehoff; J Wiltfang; Y Açil
Journal:  Clin Transl Oncol       Date:  2014-11-26       Impact factor: 3.405

7.  Pelvic fractures and changes in bone mineral density after radiotherapy for cervical, endometrial, and vaginal cancer: A prospective study of 239 women.

Authors:  Mila P Salcedo; Anil K Sood; Anuja Jhingran; Patricia J Eifel; Ann H Klopp; Revathy B Iyer; Bryan M Fellman; Camilo Jimenez; Kathleen M Schmeler
Journal:  Cancer       Date:  2020-03-03       Impact factor: 6.860

8.  Pelvic Insufficiency Fractures in Cervical Cancer After Radiation Therapy: A Meta-Analysis and Review.

Authors:  Youn Kyung Chung; Young-Kyun Lee; Byung-Ho Yoon; Dong Hoon Suh; Kyung-Hoi Koo
Journal:  In Vivo       Date:  2021 Mar-Apr       Impact factor: 2.155

9.  Analyses of the association between cervical cancer and osteoporosis/osteoporotic fracture: a cross-sectional study using KoGES HEXA data.

Authors:  Hyo Geun Choi; Jung Woo Lee; Chan Yang Min; Dae Myoung Yoo; Suk Woo Lee
Journal:  Int J Clin Oncol       Date:  2021-06-06       Impact factor: 3.402

10.  Sacral Insufficiency Fractures are Common After High-dose Radiation for Sacral Chordomas Treated With or Without Surgery.

Authors:  Polina Osler; Miriam A Bredella; Kathryn A Hess; Stein J Janssen; Christine J Park; Yen Lin Chen; Thomas F DeLaney; Francis J Hornicek; Joseph H Schwab
Journal:  Clin Orthop Relat Res       Date:  2015-09-23       Impact factor: 4.176

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