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    Insufficiency fractures in patients treated with pelvic radiotherapy and chemotherapy for uterine and cervical cancer.

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    Authors
    Mehmood, Qurrat U
    Beardwood, M
    Swindell, Ric
    Greenhalgh, S
    Wareham, T
    Barraclough, Lisa H
    Livsey, Jacqueline E
    Davidson, Susan E
    Affiliation
    Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, Manchester, UK.
    Issue Date
    2013-07-25
    
    Metadata
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    Abstract
    Insufficiency fractures are recognised consequences of radiotherapy in gynaecological malignancy with reported incidences between 2.7% and 89%. We aimed to determine the incidence and risk factors for insufficiency fractures in patients receiving radical pelvic radiotherapy for uterine and cervical cancer. A case-note review was undertaken of patients treated between January 2007 and December 2008. Insufficiency fractures were identified from radiographs, computed tomography and magnetic resonance images. Chi-squared and Mann-Whitney tests were performed to determine associations between insufficiency fractures and chemotherapy, steroids and age. A total of 285 patients received pelvic radiotherapy, 137 with uterine and 148 with cervical cancer. Mean age was 59 years. A total of 144 patients received chemotherapy, 101 concurrently and 35 adjuvantly. Bone abnormalities affected 67 patients, 33 had pelvic insufficiency fractures, 12 had multiple fractures and 3 patients developed femoral head avascular necrosis. Use of chemotherapy was not associated with development of fractures (P = 0.949). However, cervical cancer patients had a significantly higher incidence of insufficiency fractures (P = 0.018) and bone pain (P = 0.03) compared with uterine cancer patients. This suggests concurrent chemotherapy may be a significant factor in increasing insufficiency fractures and bone morbidity in these patients and highlights a need for further research to identify, prevent and reduce these long-term complications.
    Citation
    Insufficiency fractures in patients treated with pelvic radiotherapy and chemotherapy for uterine and cervical cancer. 2013: Eur J Cancer Care
    Journal
    European Journal of Cancer Care
    URI
    http://hdl.handle.net/10541/300433
    DOI
    10.1111/ecc.12105
    PubMed ID
    23889218
    Type
    Article
    Language
    en
    ISSN
    1365-2354
    ae974a485f413a2113503eed53cd6c53
    10.1111/ecc.12105
    Scopus Count
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    All Christie Publications

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