skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses

Abstract

Purpose: To investigate the relative importance of patient-reported hip and sacral pain after pelvic radiotherapy (RT) for gynecological cancer and its relationship to the absorbed doses in these organs. Methods and Materials: We used data from a population-based study that included 650 long-term gynecological cancer survivors treated with pelvic RT in the Gothenburg and Stockholm areas in Sweden with a median follow-up of 6 years (range, 2-15) and 344 population controls. Symptoms were assessed through a study-specific postal questionnaire. We also analyzed the hip and sacral dose-volume histogram data for 358 of the survivors. Results: Of the survivors, one in three reported having or having had hip pain after completing RT. Daily pain when walking was four times as common among the survivors compared to controls. Symptoms increased in frequency with a mean absorbed dose >37.5 Gy. Also, two in five survivors reported pain in the sacrum. Sacral pain also affected their walking ability and tended to increase with a mean absorbed dose >42.5 Gy. Conclusions: Long-term survivors of gynecological cancer treated with pelvic RT experience hip and sacral pain when walking. The mean absorbed dose was significantly related to hip pain and was borderline significantly related to sacral pain.more » Keeping the total mean absorbed hip dose below 37.5 Gy during treatment might lower the occurrence of long-lasting pain. In relation to the controls, the survivors had a lower occurrence of pain and pain-related symptoms from the hips and sacrum compared with what has previously been reported for the pubic bone.« less

Authors:
 [1];  [2];  [1];  [2];  [1]; ; ;  [3];  [3];  [2];  [4];  [5];  [6];  [1];  [2]
  1. Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg (Sweden)
  2. (Sweden)
  3. Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm (Sweden)
  4. Department of Bioinformatics and Computational Biology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
  5. Department of Gynecologic Oncology, Karolinska University Hospital, Stockholm (Sweden)
  6. Department of Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg (Sweden)
Publication Date:
OSTI Identifier:
22149519
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 84; Journal Issue: 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; NEOPLASMS; PAIN; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SKELETON

Citation Formats

Waldenstroem, Ann-Charlotte, E-mail: ann-charlotte.waldenstrom@oncology.gu.se, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Olsson, Caroline, Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Wilderaeng, Ulrica, Dunberger, Gail, Lind, Helena, Alevronta, Eleftheria, Al-Abany, Massoud, Department of Hospital Physics, Karolinska University Hospital, Stockholm, Tucker, Susan, Avall-Lundqvist, Elisabeth, Johansson, Karl-Axel, Steineck, Gunnar, and Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm. Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.008.
Waldenstroem, Ann-Charlotte, E-mail: ann-charlotte.waldenstrom@oncology.gu.se, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Olsson, Caroline, Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Wilderaeng, Ulrica, Dunberger, Gail, Lind, Helena, Alevronta, Eleftheria, Al-Abany, Massoud, Department of Hospital Physics, Karolinska University Hospital, Stockholm, Tucker, Susan, Avall-Lundqvist, Elisabeth, Johansson, Karl-Axel, Steineck, Gunnar, & Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm. Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses. United States. doi:10.1016/J.IJROBP.2011.12.008.
Waldenstroem, Ann-Charlotte, E-mail: ann-charlotte.waldenstrom@oncology.gu.se, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Olsson, Caroline, Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Wilderaeng, Ulrica, Dunberger, Gail, Lind, Helena, Alevronta, Eleftheria, Al-Abany, Massoud, Department of Hospital Physics, Karolinska University Hospital, Stockholm, Tucker, Susan, Avall-Lundqvist, Elisabeth, Johansson, Karl-Axel, Steineck, Gunnar, and Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm. Mon . "Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses". United States. doi:10.1016/J.IJROBP.2011.12.008.
@article{osti_22149519,
title = {Relative Importance of Hip and Sacral Pain Among Long-Term Gynecological Cancer Survivors Treated With Pelvic Radiotherapy and Their Relationships to Mean Absorbed Doses},
author = {Waldenstroem, Ann-Charlotte, E-mail: ann-charlotte.waldenstrom@oncology.gu.se and Department of Oncology, Sahlgrenska University Hospital, Gothenburg and Olsson, Caroline and Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg and Wilderaeng, Ulrica and Dunberger, Gail and Lind, Helena and Alevronta, Eleftheria and Al-Abany, Massoud and Department of Hospital Physics, Karolinska University Hospital, Stockholm and Tucker, Susan and Avall-Lundqvist, Elisabeth and Johansson, Karl-Axel and Steineck, Gunnar and Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institute, Stockholm},
abstractNote = {Purpose: To investigate the relative importance of patient-reported hip and sacral pain after pelvic radiotherapy (RT) for gynecological cancer and its relationship to the absorbed doses in these organs. Methods and Materials: We used data from a population-based study that included 650 long-term gynecological cancer survivors treated with pelvic RT in the Gothenburg and Stockholm areas in Sweden with a median follow-up of 6 years (range, 2-15) and 344 population controls. Symptoms were assessed through a study-specific postal questionnaire. We also analyzed the hip and sacral dose-volume histogram data for 358 of the survivors. Results: Of the survivors, one in three reported having or having had hip pain after completing RT. Daily pain when walking was four times as common among the survivors compared to controls. Symptoms increased in frequency with a mean absorbed dose >37.5 Gy. Also, two in five survivors reported pain in the sacrum. Sacral pain also affected their walking ability and tended to increase with a mean absorbed dose >42.5 Gy. Conclusions: Long-term survivors of gynecological cancer treated with pelvic RT experience hip and sacral pain when walking. The mean absorbed dose was significantly related to hip pain and was borderline significantly related to sacral pain. Keeping the total mean absorbed hip dose below 37.5 Gy during treatment might lower the occurrence of long-lasting pain. In relation to the controls, the survivors had a lower occurrence of pain and pain-related symptoms from the hips and sacrum compared with what has previously been reported for the pubic bone.},
doi = {10.1016/J.IJROBP.2011.12.008},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 84,
place = {United States},
year = {Mon Oct 01 00:00:00 EDT 2012},
month = {Mon Oct 01 00:00:00 EDT 2012}
}