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Title: Insufficiency Fractures After Pelvic Radiotherapy in Patients With Prostate Cancer

Purpose: To assess the incidence, predisposing factors, and clinical characteristics of insufficiency fractures (IF) in patients with prostate cancer, who received pelvic radiotherapy as part of their definitive treatment. Methods and Materials: The charts of 134 prostate cancer patients, who were treated with pelvic radiotherapy between 1998 and 2007 were retrospectively reviewed. IF was diagnosed by bone scan and/or CT and/or MRI. The cumulative incidence of symptomatic IF was estimated by actuarial methods. Results: Eight patients were identified with symptomatic IF after a median follow-up period of 68 months (range, 12-116 months). The 5-year cumulative incidence of symptomatic IF was 6.8%. All patients presented with lower back pain. Insufficiency fracture developed at a median time of 20 months after the end of radiotherapy and was managed conservatively without any need for hospitalization. Three patients were thought to have metastatic disease because of increased uptake in their bone scans. However, subsequent CT and MR imaging revealed characteristic changes of IF, avoiding any further intervention. No predisposing factors for development of IF could be identified. Conclusions: Pelvic IF is a rare complication of pelvic radiotherapy in prostate cancer. Knowledge of pelvic IF is essential to rule out metastatic disease and prevent unnecessarymore » treatment, especially in a patient cohort with high-risk features for distant spread.« less
Authors:
 [1] ; ;  [2] ;  [3] ;  [4] ;  [5] ;  [2] ;  [1]
  1. Department of Radiation Oncology, Istanbul Bilim University, Istanbul (Turkey)
  2. Department of Radiation Oncology, Florence Nightingale Gayrettepe Hospital, Istanbul (Turkey)
  3. Department of Radiology, Florence Nightingale Gayrettepe Hospital, Istanbul (Turkey)
  4. Department of Radiology, Florence Nightingale Sisli Hospital, Istanbul (Turkey)
  5. Department of Nuclear Medicine, Florence Nightingale Gayrettepe Hospital, Istanbul (Turkey)
Publication Date:
OSTI Identifier:
21436042
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 77; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2009.05.059; PII: S0360-3016 (09)00906-7; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FRACTURES; HEALTH HAZARDS; NEOPLASMS; PELVIS; PROSTATE; RADIOTHERAPY BODY; DISEASES; FAILURES; GLANDS; HAZARDS; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY