Femoral neck fracture and central migration of the artificial femoral head after carbon ion radiotherapy for chondrosarcoma in the pelvis

Sumiyoshi, Nobuhiko; Torigoe, Tomoaki; Maezawa, Katsuhiko; Narushima, Yasuhiro; Maruyama, Yoshihiro; Imai, Reiko; Kamada, Tadashi

doi:10.1016/j.jos.2016.07.014

Cited by 3 publications

(2 citation statements)

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“…[16][17][18][19][20][21][22] Several complications have been reported to be associated with CIRT for pelvic bone tumors, including femoral head necrosis and neurological deficits. [23][24][25] However, to the best of our knowledge, the frequency and risk factors relating to these complications remain unclear, and the functional outcomes and quality of life (QOL) after CIRT have not been investigated to date.…”

Section: Introductionmentioning

confidence: 99%

Complication rate, functional outcomes, and risk factors associated with carbon ion radiotherapy for patients with unresectable pelvic bone sarcoma

Takenaka

Araki

Outani

et al. 2020

Cancer

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Background To the authors' knowledge, carbon ion radiotherapy (CIRT) is one of the few curative treatments for unresectable pelvic bone sarcoma. The current study investigated the complications, functional outcomes, and risk factors of CIRT. Methods Of 112 patients who were treated with CIRT for unresectable pelvic bone sarcoma, the authors enrolled 29 patients who were without local disease recurrence or distant metastasis. The mean follow‐up was 93 months. Complications, functional outcomes, and quality of life scores were assessed. Risk factors were analyzed, including the dose‐volume histogram of the femoral head. Results Femoral head necrosis occurred in approximately 37% of patients, pelvic fractures were reported in 48% of patients, and neurological deficits were noted in 52% of patients. Femoral head necrosis was found to be significantly more prevalent among patients with periacetabular tumors (P = .018). The dose‐volume histogram of the femoral head indicated tolerable volume percentages of the femoral head to be <33% for 40 grays (relative biological effectiveness) and 16% for 60 grays ( relative biological effectiveness). The mean Musculoskeletal Tumor Society score and Toronto Extremity Salvage Score were 53% and 64%, respectively, and the mean EuroQol 5 dimensions questionnaire index was 0.587. Patients aged >50 years and those with periacetabular tumors were found to have significantly lower Toronto Extremity Salvage Scores. Conclusions Femoral head necrosis, pelvic fracture, and nerve damage are common complications with the use of CIRT for pelvic bone sarcoma. To prevent femoral head necrosis, the radiation dose to the femoral head should be kept below the estimated tolerance curve presented in the current study. The functional outcome is nearly equivalent to that of surgery. CIRT may be a promising alternative to surgery for patients with unresectable pelvic bone sarcoma.

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Section: Introductionmentioning

confidence: 99%

Complication rate, functional outcomes, and risk factors associated with carbon ion radiotherapy for patients with unresectable pelvic bone sarcoma

Takenaka

Araki

Outani

et al. 2020

Cancer

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“…Indelicato et al reported only one thoracic fracture requiring fusion surgery among proton therapy treatment of 51 patients with spinal CS [ 24 ]. Sumiyoshi et al reported a case of low-grade CS at the left ileum treated with CIRT 70.4 GyE in 16 fractions that developed femoral neck fracture at 21 months after treatment [ 28 ]. The patient underwent left hemiarthroplasty and the pathological report showed osteonecrosis, indicating a radiation-induced mechanism.…”

Section: Discussionmentioning

confidence: 99%

Prospective study to evaluate the safety of the world-first spot-scanning dedicated, small 360-degree gantry, synchrotron-based proton beam therapy system

Nishioka

Prayongrat

Ono

et al. 2018

Journal of Radiation Research

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This is a report of a single-institution prospective study evaluating the safety of a spot-scanning dedicated, small 360-degree gantry, synchrotron-based proton beam therapy (PBT) system. Data collection was performed for 56 patients with 59 treatment sites who received proton beam therapy at Hokkaido University Hospital between March 2014 and July 2015. Forty-one patients were male and 15 were female. The median age was 66 years. The primary lesion sites were prostate (n = 17), bone/soft tissue (n = 10), liver (n = 7), lung (n = 6), central nervous system (n = 5), colon (n = 2), pancreas (n = 2), kidney (n = 2) and others (n = 5). Chemotherapy was administered in 11 patients. The prescribed total dose was from 20 to 76 GyE (Radiobiological equivalent dose, RBE = 1.1), with the median dose of 65 GyE in 4 to 35 fractions. No PBT-related Common Terminology Criteria for Adverse Events Grade 4 or 5 toxicities were observed; the incidence of early PBT-related Grade 4 adverse events was 0% (95% confidence interval 0 to 6.38%). The most common Grade 3 toxicities were hematologic toxicity (12.5%) unlikely to be related to the PBT. One patient developed a left femoral neck fracture (Grade 3) at 14.5 months after PBT for chondrosarcoma of the left pelvis. The pathological findings showed no other malignancies, suggesting that it was possibly related to the PBT. In conclusion, the spot-scanning dedicated, synchrotron-based PBT system is feasible, but further studies on its long-term safety and efficacy are warranted.

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骨盤骨肉腫に対する重粒子線治療後に大腿骨頚部骨折を来した1例

2018

Orthopedics & Traumatology

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Femoral neck fracture and central migration of the artificial femoral head after carbon ion radiotherapy for chondrosarcoma in the pelvis

Cited by 3 publications

References 6 publications

Complication rate, functional outcomes, and risk factors associated with carbon ion radiotherapy for patients with unresectable pelvic bone sarcoma

Complication rate, functional outcomes, and risk factors associated with carbon ion radiotherapy for patients with unresectable pelvic bone sarcoma

Prospective study to evaluate the safety of the world-first spot-scanning dedicated, small 360-degree gantry, synchrotron-based proton beam therapy system

骨盤骨肉腫に対する重粒子線治療後に大腿骨頚部骨折を来した1例

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