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Femoral neck fracture following groin irradiation

Abstract

Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a  More>>
Publication Date:
Apr 30, 1995
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 32; Journal Issue: 1; Other Information: Copyright (c) 1995 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); PBD: 30 Apr 1995
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; AGE DEPENDENCE; ALCOHOLS; BONE FRACTURES; CARCINOMAS; DOSE-RESPONSE RELATIONSHIPS; ESTROGENS; FEMALE GENITALS; FEMUR; MENOPAUSE; NEOPLASMS; OSTEOPOROSIS; PELVIS; PHOTON BEAMS; RADIOTHERAPY; TOBACCO PRODUCTS; UROGENITAL SYSTEM DISEASES; UTERUS
OSTI ID:
20391093
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US03R1515057440
Submitting Site:
INIS
Size:
page(s) 63-67
Announcement Date:
Nov 20, 2003

Citation Formats

Grigsby, Perry W, Roberts, Heidi L, and Perez, Carlos A. Femoral neck fracture following groin irradiation. United States: N. p., 1995. Web. doi:10.1016/0360-3016(95)00546-B.
Grigsby, Perry W, Roberts, Heidi L, & Perez, Carlos A. Femoral neck fracture following groin irradiation. United States. https://doi.org/10.1016/0360-3016(95)00546-B
Grigsby, Perry W, Roberts, Heidi L, and Perez, Carlos A. 1995. "Femoral neck fracture following groin irradiation." United States. https://doi.org/10.1016/0360-3016(95)00546-B.
@misc{etde_20391093,
title = {Femoral neck fracture following groin irradiation}
author = {Grigsby, Perry W, Roberts, Heidi L, and Perez, Carlos A}
abstractNote = {Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication.}
doi = {10.1016/0360-3016(95)00546-B}
journal = []
issue = {1}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Apr}
}