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A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification

Abstract

Purpose: To ascertain whether the time from injury to prophylactic radiation therapy (RT) influences the rate of heterotopic ossification (HO) after operative treatment of displaced acetabular fractures. Methods and Materials: This is a single-institution, retrospective analysis of patients referred for RT for the prevention of HO. Between January 2000 and January 2009, 585 patients with displaced acetabular fractures were treated surgically followed by RT for HO prevention. We analyzed the effect of time from injury on prevention of HO by RT. In all patients, 700 cGy was prescribed in a single fraction and delivered within 72 hours postsurgery. The patients were stratified into five groups according to time interval (in days) from the date of their accident to the date of RT: Groups A {<=}3, B {<=}7, C {<=}14, D {<=}21, and E >21days. Results: Of the 585 patients with displaced acetabular fractures treated with RT, (18%) 106 patients developed HO within the irradiated field. The risk of HO after RT increased from 10% for RT delivered {<=}3 days to 92% for treatment delivered >21 days after the initial injury. Wilcoxon test showed a significant correlation between the risk of HO and the length of time from injury to RT  More>>
Authors:
Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel)]; Packianathan, Satyaseelan; [1]  Shourbaji, Rania A; [2]  Zhen, Zhang; Graves, Mathew; [3]  Khan, Majid A; [4]  Baird, Michael C; [1]  Russell, George; [3]  Vijayakumar, Srinivasan [1] 
  1. Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States)
  2. Department of Epidemiology and Biostatistics, Jackson State University, Jackson, MS (United States)
  3. Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States)
  4. Department of Radiology, University of Mississippi Medical Center, Jackson, MS (United States)
Publication Date:
Mar 01, 2012
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 82; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FRACTURES; HAZARDS; INJURIES; PATIENTS; PREVENTIVE MEDICINE; RADIOTHERAPY; REGRESSION ANALYSIS; SURGERY
OSTI ID:
22056090
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; CODEN: IOBPD3; Other: PII: S0360-3016(11)02869-0; TRN: US12R2415016471
Availability:
Available from http://dx.doi.org/10.1016/j.ijrobp.2011.06.1981
Submitting Site:
USN
Size:
page(s) e339-e344
Announcement Date:
Feb 21, 2013

Citation Formats

Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States), Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel)], Packianathan, Satyaseelan, Shourbaji, Rania A, Zhen, Zhang, Graves, Mathew, Khan, Majid A, Baird, Michael C, Russell, George, and Vijayakumar, Srinivasan. A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.06.1981.
Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States), Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel)], Packianathan, Satyaseelan, Shourbaji, Rania A, Zhen, Zhang, Graves, Mathew, Khan, Majid A, Baird, Michael C, Russell, George, &amp; Vijayakumar, Srinivasan. A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification. United States. https://doi.org/10.1016/J.IJROBP.2011.06.1981
Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States), Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel)], Packianathan, Satyaseelan, Shourbaji, Rania A, Zhen, Zhang, Graves, Mathew, Khan, Majid A, Baird, Michael C, Russell, George, and Vijayakumar, Srinivasan. 2012. "A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification." United States. https://doi.org/10.1016/J.IJROBP.2011.06.1981.
@misc{etde_22056090,
title = {A Prolonged Time Interval Between Trauma and Prophylactic Radiation Therapy Significantly Increases the Risk of Heterotopic Ossification}
author = {Mourad, Waleed F., E-mail: Waleed246@gmail.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States), Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel)], Packianathan, Satyaseelan, Shourbaji, Rania A, Zhen, Zhang, Graves, Mathew, Khan, Majid A, Baird, Michael C, Russell, George, and Vijayakumar, Srinivasan}
abstractNote = {Purpose: To ascertain whether the time from injury to prophylactic radiation therapy (RT) influences the rate of heterotopic ossification (HO) after operative treatment of displaced acetabular fractures. Methods and Materials: This is a single-institution, retrospective analysis of patients referred for RT for the prevention of HO. Between January 2000 and January 2009, 585 patients with displaced acetabular fractures were treated surgically followed by RT for HO prevention. We analyzed the effect of time from injury on prevention of HO by RT. In all patients, 700 cGy was prescribed in a single fraction and delivered within 72 hours postsurgery. The patients were stratified into five groups according to time interval (in days) from the date of their accident to the date of RT: Groups A {<=}3, B {<=}7, C {<=}14, D {<=}21, and E >21days. Results: Of the 585 patients with displaced acetabular fractures treated with RT, (18%) 106 patients developed HO within the irradiated field. The risk of HO after RT increased from 10% for RT delivered {<=}3 days to 92% for treatment delivered >21 days after the initial injury. Wilcoxon test showed a significant correlation between the risk of HO and the length of time from injury to RT (p < 0.0001). Chi-square test and multiple logistic regression analysis showed no significant association between all other factors and the risk of HO (race, gender, cause and type of fracture, surgical approach, or the use of indomethacin). Conclusions: Our data suggest that there is higher incidence and risk of HO if prophylactic RT is significantly delayed after a displaced acetabular fracture. Thus, RT should be administered as early as clinically possible after the trauma. Patients undergoing RT >3 weeks from their displaced acetabular fracture should be informed of the higher risk (>90%) of developing HO despite prophylaxis.}
doi = {10.1016/J.IJROBP.2011.06.1981}
journal = []
issue = {3}
volume = {82}
journal type = {AC}
place = {United States}
year = {2012}
month = {Mar}
}