The incidence and risk factors of pelvic insufficiency fracture in patients with cervical cancer after intensity-modulated radiotherapy
10.3760/cma.j.issn.0254-5098.2017.03.006
- VernacularTitle:宫颈癌调强放疗后骨盆衰竭骨折的发生率及影响因素分析
- Author:
Hongjuan YANG
;
Nuerjiang SHUAKE
;
Conghua XIE
- Keywords:
Cervical cancer;
Intensity modulated radiotherapy;
Pelvic insufficiency fractures
- From:
Chinese Journal of Radiological Medicine and Protection
2017;37(3):193-198
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the incidence and risk factors of pelvic insufficiency fractures (PIF) in patients with cervical cancer who received pelvic intensity-modulated radiotherapy.Methods This study a retrospective review of all patients was performed with cervical cancer who received pelvic intensity-modulated radiotherapy at our institution from November 2013 to December 2015,and the incidence and risk factors of insufficiency fractures were analyzed.Results Among the 104 patients,16 (with a total of 31 lesions) were diagnosed with pelvic insufficiency fracture.The occurrence rate of pelvic insufficiency was 15.4%.Ten patients (62.5%) had multiple fractures and five patients (31%) complained of pain.All patients' pain was relieved by rest or analgesic drugs.Insufficiency fractures were detected at a median of 6.5 months (range 1-16) from radiotherapy completion.The distribution of PIFs was followed:sacral had 16 cases (51.6%),sacroiliac joint had 7 cases (22.6%),iliac had 6 cases (19.4%),femoral head had 1 case (3.2%) and pubis had 1 case (3.2%).Univariate analysis and multiple analysis showed that postmenopausal status and low body weight (≤55 kg) were thought to be risk factors for PIF(P < 0.05).Subgroup analysis also confirmed that postmenopausal status was a risk factor for PIF (P < 0.05) in postoperative cervical cancer patients after pelvic intensity-modulated radiation therapy.Conclusions Cervical cancer patients with menopausal status and low body weight (≤55 kg) are at some risk for the development of PIF after pelvic intensity-modulated radiotherapy.