Effects of Radiation on Bone

Pacheco, Rafael A.; Stock, Harlan

doi:10.1007/s11914-013-0174-z

Cited by 84 publications

(53 citation statements)

References 23 publications

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“…14 Radiation has been shown to harm bone through numerous localized and systemic effects, often leading to ablation of the vascular supply, decreased osteoblast and increased osteoclast activity, replacement of biologically active red marrow with inactive yellow marrow, chondrocyte loss, 13 and direct destruction of collagen and inorganic matrix. 7 While the majority of radiation-associated osseous toxicity mechanisms result in delayed toxicity, acute toxicity due to direct injury to the bone matrix is possible.…”

Section: Discussionmentioning

confidence: 99%

Frequency of symptomatic vertebral body compression fractures requiring intervention following single-fraction stereotactic radiosurgery for spinal metastases

Virk

Han

Reiner

et al. 2017

FOC

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OBJECTIVE The purpose of this study was to determine the rate of symptomatic vertebral body compression fractures (VCFs) requiring kyphoplasty or surgery in patients treated with 24-Gy single-fraction stereotactic radiosurgery (SRS). METHODS This retrospective analysis included all patients who had been treated with 24-Gy, single-fraction, image-guided intensity-modulated radiation therapy for histologically confirmed solid tumor metastases over an 8-year period (2005–2013) at Memorial Sloan Kettering Cancer Center. Charts and imaging studies were reviewed for post-SRS kyphoplasty or surgery for mechanical instability. A Spinal Instability Neoplastic Score (SINS) was calculated for each patient both at the time of SRS and at the time of intervention for VCF. RESULTS Three hundred twenty-three patients who had undergone single-fraction SRS between C-1 and L-5 were included in this analysis. The cumulative incidence of VCF 5 years after SRS was 7.2% (95% CI 4.1–10.2), whereas that of death following SRS at the same time point was 82.5% (95% CI 77.5–87.4). Twenty-six patients with 36 SRS-treated levels progressed to symptomatic VCF requiring treatment with kyphoplasty (6 patients), surgery (10 patients), or both (10 patients). The median time to symptomatic VCF was 13 months. Seven patients developed VCF at 11 levels adjacent to the SRS-treated level. Fractured levels had no evidence of tumor progression. The median SINS changed from 6.5 at SRS (interquartile range [IQR] 4.3–8.8) to 11.5 at stabilization (IQR 9–13). In patients without prior stabilization at the level of SRS, there was an association between the SINS and the time to fracture. CONCLUSIONS Five years after ablative single-fraction SRS to spinal lesions, the cumulative incidence of symptomatic VCF at the treated level without tumor recurrence was 7.2%. Higher SINSs at the time of SRS correlated with earlier fractures.

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Section: Discussionmentioning

confidence: 99%

Frequency of symptomatic vertebral body compression fractures requiring intervention following single-fraction stereotactic radiosurgery for spinal metastases

Virk

Han

Reiner

et al. 2017

FOC

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“…Another key benefit of LDCT is the increased feasibility of radiological examinations in patients predisposed to other pathological skeletal conditions. It has been shown that patients undergoing cancer treatments, in the form of radiation therapy, experience insufficiency fractures43. As such, subjecting them to additional CT-based radiation for diagnostic evaluation of bone loss may not be practical, because of a probable risk of radiation-induced malignancy44 or fear of aggravated bone loss, leading to secondary bone fractures.…”

Section: Discussionmentioning

confidence: 99%

Effects of dose reduction on bone strength prediction using finite element analysis

Anitha

Subburaj

Mei

et al. 2016

Sci Rep

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This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests were used to compare the results obtained, using the highest CT dose (500 mAs) as reference. Dose reduction had no significant impact on FE-predicted fracture loads, with significant correlations obtained with reference to 500 mAs, for 80 mAs (R2 = 0.997, p < 0.001), 150 mAs (R2 = 0.998, p < 0.001) and 220 mAs (R2 = 0.987, p < 0.001). There were no significant differences in volume quantification between the different doses examined. CT imaging radiation dose could be reduced substantially to 64% with no impact on strength estimates obtained from FE analysis. Reduced CT dose will enable early diagnosis and advanced monitoring of osteoporosis and associated fracture risk.

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“…In bone tissue, ionizing radiation results in apoptosis of bone and endothelial cells, reduced metabolism, decreased vascularity and changes in remodeling (Pacheco and Stock, ). These changes result in modifications in the network of bone channels, reduction in bone matrix and amounts of calcium and phosphorus, and lead to biomechanical impairment and bone growth arrest (Rabelo et al, ).…”

Section: Introductionmentioning

confidence: 99%

The effects of ionizing radiation on the growth plate in rat tibiae

Rocha¹,

Limirio²,

Zanetta‐Barbosa³

et al. 2016

Microscopy Res & Technique

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The deleterious effects of ionizing radiation on the growth plate continue to be cause for concern. This study evaluated the ionizing radiation effects on bone development and growth plate in the tibia of rats. All animals were submitted to ionizing radiation on the left leg. The animals were divided into two groups and euthanized 30 and 60 days after radiation. The tibiae were removed and separated into groups: control 30 days, irradiated 30 days, control 60 days and irradiated 60 days. Animals in each group (n = 7) were used for macroscopic and histological analysis. The irradiated tibiae showed arrested growth, angular deformity and limb length discrepancy when compared with nonirradiated tibiae. There was statistical difference between control and radiation groups in all the parameters analyzed, except in the lateral-medial thickness of the distal epiphysis. Histological analysis showed evident changes in the growth plate, which was thicker in the Groups irradiated for 30 days, and irradiated for 60 days, compared with their respective controls. The growth plate showed wide areas with disorganized zones of chondrocytes and severely reduced calcification zone. It was concluded that ionizing radiation damaged the growth plate, compromised the endochondral ossification process, and resulted in complete arrest of bone development.

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Effects of Radiation on Bone

Cited by 84 publications

References 23 publications

Frequency of symptomatic vertebral body compression fractures requiring intervention following single-fraction stereotactic radiosurgery for spinal metastases

Frequency of symptomatic vertebral body compression fractures requiring intervention following single-fraction stereotactic radiosurgery for spinal metastases

Effects of dose reduction on bone strength prediction using finite element analysis

The effects of ionizing radiation on the growth plate in rat tibiae

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