BACKGROUND: Avascular necrosis (AVN) refers to the death of osteocytes and osteoblasts. Sites such as the femoral head, the head of the humerus and the mandibula with restricted access to local blood supply are particularly vulnerable to osteonecrosis. A COMBINATION OF SEVERAL FACTORS IS RESPONSIBLE FOR ISCHAEMIA AND IS ASSOCIATED WITH AVN: corticosteroids, alcohol abuse, Cushing's syndrome, SLE, systemic vasculitis, RA, scleroderma, haemoglobinopathies, radiotherapy. Management is based on proper diagnosis and treatment - conservative, pharmacological or surgical. Radiotherapy has become an integral part of the therapeutic programme of cancer patients. However, early and late after-effects of irradiation still constitute a significant issue in clinical practice. AIM: The aim of this report is to present two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic irradiation and draw physicians' attention to that clinical problem which continues to be underestimated. MATERIALS AND METHODS: This report documents two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic radiation. RESULTS: Avascular necrosis (AVN) constitutes a severe and challenging long-term complication in radiation oncology. CONCLUSION: It is necessary to take into account bone structures among organ at risk (OAR) involved in irradiation fields. The detailed analysis of the dose distribution and the use of collimators allow to decrease the total dose to OAR. An adequate management, early diagnosis and prompt, proper treatment may protect patients from long-term morbidities.
BACKGROUND:Avascular necrosis (AVN) refers to the death of osteocytes and osteoblasts. Sites such as the femoral head, the head of the humerus and the mandibula with restricted access to local blood supply are particularly vulnerable to osteonecrosis. A COMBINATION OF SEVERAL FACTORS IS RESPONSIBLE FOR ISCHAEMIA AND IS ASSOCIATED WITH AVN: corticosteroids, alcohol abuse, Cushing's syndrome, SLE, systemic vasculitis, RA, scleroderma, haemoglobinopathies, radiotherapy. Management is based on proper diagnosis and treatment - conservative, pharmacological or surgical. Radiotherapy has become an integral part of the therapeutic programme of cancerpatients. However, early and late after-effects of irradiation still constitute a significant issue in clinical practice. AIM: The aim of this report is to present two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic irradiation and draw physicians' attention to that clinical problem which continues to be underestimated. MATERIALS AND METHODS: This report documents two cases of acetabular protrusion and femoral head deformities after a therapeutic pelvic radiation. RESULTS:Avascular necrosis (AVN) constitutes a severe and challenging long-term complication in radiation oncology. CONCLUSION: It is necessary to take into account bone structures among organ at risk (OAR) involved in irradiation fields. The detailed analysis of the dose distribution and the use of collimators allow to decrease the total dose to OAR. An adequate management, early diagnosis and prompt, proper treatment may protect patients from long-term morbidities.
Authors: John P Micha; Bram H Goldstein; Mark A Rettenmaier; James T Caillouette; Martin J Fee; John V Brown Journal: Gynecol Oncol Date: 2006-01-26 Impact factor: 5.482
Authors: Michael P Herman; Scott Kopetz; Priya R Bhosale; Cathy Eng; John M Skibber; Miguel A Rodriguez-Bigas; Barry W Feig; George J Chang; Marc E Delclos; Sunil Krishnan; Christopher H Crane; Prajnan Das Journal: Int J Radiat Oncol Biol Phys Date: 2009-01-13 Impact factor: 7.038
Authors: Colleen I Dickie; Amy L Parent; Anthony M Griffin; Sharon Fung; Peter W M Chung; Charles N Catton; Peter C Ferguson; Jay S Wunder; Robert S Bell; Michael B Sharpe; Brian O'Sullivan Journal: Int J Radiat Oncol Biol Phys Date: 2009-04-11 Impact factor: 7.038