Avascular Necrosis of the Femoral Head After Palliative Radiotherapy in Metastatic Prostate Cancer: Absence of a Dose Threshold?

Daoud, Alia; Magnus, Kenneth G.; Huang, Fleur; Danielson, Brita; Venner, Peter; Saluja, Ronak; LeGuerrier, Bronwen; Daly, Helene; Emmenegger, Urban; Fairchild, Alysa

doi:10.7759/cureus.521

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…The reference lists of the retrieved papers are also searched to identify further research. The literature on hip ORN thus far mainly consists of case series and case reports (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). We review case reports published between 1980 and 2020.…”

Section: Resultsmentioning

confidence: 99%

Osteoradionecrosis of the Hip, a Troublesome Complication of Radiation Therapy: Case Series and Systematic Review

Tang

Shen

et al. 2022

Front. Med.

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BackgroundOsteoradionecrosis of the hip is a serious complication of radiotherapy that is easily overlooked by physicians and patients in the early stages. There are relatively few reports on this subject, so there is no clear scientific consensus for the pathogenesis, early diagnosis, and clinical treatment of hip osteoradionecrosis. In this paper, we report two cases of hip osteoradionecrosis and systematically review the related literature.Case PresentationWe report two cases of hip osteoradionecrosis. One patient successfully underwent total hip arthroplasty in our hospital and recovered well postoperatively. Another patient although we offered a variety of surgical options for this patient, the patient was worried that the bone loss would lead to poor prosthesis fixation, resulting in prosthesis loosening and infection, and therefore ultimately refused surgical treatment.ConclusionWith the development of radiological techniques, the incidence of hip osteoradionecrosis is decreasing year by year, but early diagnosis and rational treatment remain challenging. The effects of non-surgical treatment are limited. Early prevention, early detection, and early intervention are crucial to delay or prevent the emergence of more serious complications.

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Section: Resultsmentioning

confidence: 99%

Osteoradionecrosis of the Hip, a Troublesome Complication of Radiation Therapy: Case Series and Systematic Review

Tang

Shen

et al. 2022

Front. Med.

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“…Additionally, fat cell hypertrophy, fat embolization, intravascular coagulation [ 1 ], and osteocyte apoptosis [ 22 ] have been suggested as important hypotheses for pathogenetic mechanism of ONFH. Several studies have investigated the association between ONFH and specific diseases to understand the pathogenesis of non-traumatic ONFH, in which bone cell death from compromised microvascular circulation is believed the result of trauma, corticosteroid, alcohol use, blood dyscrasias as well as other conditions such as Gaucher disease, Caisson disease, HIV, SLE, radiation treatment, pregnancy, inflammatory bowel disease, gout, smoking, and even malignant tumors [ 23 – 32 ]. Regarding the association with solid tumor, ONFH has been recognized as a complication of cancer chemotherapy for testicular, breast, ovarian, small-cell lung cancer and osteosarcoma, with prolonged and intensive steroid exposure usually implicated as the main risk factor [ 11 – 14 , 33 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for osteonecrosis of the femoral head in brain tumor patients receiving corticosteroid after surgery

et al. 2020

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Non-traumatic osteonecrosis of the femoral head (ONFH) is a plausible complication in brain tumor patients. Frequent use of corticosteroid therapy, chemotherapy, and oxidative stress for managing brain tumors may be associated with the development of ONFH. However, there is little knowledge on the prevalence and risk factors of ONFH from brain tumor. This study aimed to investigate the prevalence and risk factors of ONFH in patients with primary brain tumors. Methods This retrospective cohort study included data from consecutive patients between December 2005 and August 2016 from a tertiary university hospital in South Korea. A total of 73 cases of ONFH were identified among 10,674 primary brain tumor patients. After excluding subjects (25 out of 73) with missing data, history of alcohol consumption or smoking, history of femoral bone trauma or surgery, comorbidities such as systemic lupus erythematosus (SLE), sickle cell disease, cancer patients other than brain tumor, and previous diagnosis of contralateral ONFH, we performed a 1:2 propensity score-matched, case-control study (ONFH group, 48; control group, 96). Risk factors of ONFH in primary brain tumor were evaluated by univariate and multivariate logistic regression analyses. Results The prevalence of ONFH in patients with surgical resection of primary brain tumor was 683.9 per 100,000 persons (73 of 10,674). In this cohort, 55 of 74 patients (74.3%) underwent THA for ONFH treatment. We found that diabetes was an independent factor associated with an increased risk of ONFH in primary brain tumor patients (OR = 7.201, 95% CI, 1.349-38.453, p = 0.021). There was a significant difference in univariate analysis, including

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“…Research and collaboration with other professionals on a multitude of connected projects keeps the role interesting and engaging, connecting MDT members on shared academic projects in addition to fostering clinical partnerships. Examples of MDT research involvement include academic studies initiated by PRTs [16,26], case reports [27], involvement in MDT survival prediction [28], and an international initiative aimed at understanding MDT behavior [24].…”

Section: Evolution: Co-navigation For All Indications November 2012-december 2014mentioning

confidence: 99%

Evolution of the Radiation Therapist Role in a Multidisciplinary Palliative Radiation Oncology Clinic

LeGuerrier¹,

Huang²,

Spence³

et al. 2019

Journal of Medical Imaging and Radiation Sciences

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Background: Palliative radiation therapists (PRTs) have been integrated in varying capacities into outpatient palliative radiation therapy (RT) services across Canada for over 2 decades. At our institution, PRTs have developed an essential role over 11 years within a palliative radiation oncology (PRO) clinic that focuses on integrating symptom management with radiation oncology assessment for palliative RT. PRTs have had direct clinical, technical, research, and administrative involvement as the clinic evolved from a pilot in 2007 supporting one half-day per week to the current model of five full clinical days.Methods: Using collaborative reflection, we explored the PRTs' experience and insight. Twelve PRTs who contributed to the PRO clinic for varying lengths of time from 2007 through to 2016 were invited to participate in the development of a collective expression of the PRT experience. Seven PRTs consented to completing an electronic survey consisting of fifteen open-ended questions regarding individual roles and perspectives relating to our PRO clinic. Survey answers were enhanced by semistructured interviews when needed for clarification. Responses were contextualized within the operational changes to our multidisciplinary clinical model, from pilot to integrated service.Results/Discussion: Five respondents answered all of the questions. From the narratives, PRT roles and responsibilities were outlined and their insights and reflections included to contextualize clinical changes. Four phases of the clinic were identified and elucidated. Beginning in January 2007, three PRTs staffed a multidisciplinary clinical pilot one half-day per week for single-fraction, symptomatic bone metastases. The clinic has now evolved through various iterations to the current model with four PRTs sharing a ''navigator'' role with two registered nurses five full clinic days per week. The range of PRT experiences, responsibilities, and challenges encountered reflected specific clinical and operational conditions.

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Avascular Necrosis of the Femoral Head After Palliative Radiotherapy in Metastatic Prostate Cancer: Absence of a Dose Threshold?

Cited by 5 publications

References 15 publications

Osteoradionecrosis of the Hip, a Troublesome Complication of Radiation Therapy: Case Series and Systematic Review

Osteoradionecrosis of the Hip, a Troublesome Complication of Radiation Therapy: Case Series and Systematic Review

Risk factors for osteonecrosis of the femoral head in brain tumor patients receiving corticosteroid after surgery

Evolution of the Radiation Therapist Role in a Multidisciplinary Palliative Radiation Oncology Clinic

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