Insufficiency Fractures After Pelvic Radiotherapy in Patients With Prostate Cancer

Igdem, Sefik; Alço, Gül; Ercan, T.; Barlan, Metin; Ganiyusufoglu, Kuersat; Ünalan, B.; Türkan, Sedat; Okkan, Sait

doi:10.1016/j.ijrobp.2009.05.059

Cited by 68 publications

(55 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The combination of these effects results in a reduction in the bone mineral density (BMD) in patients undergoing pelvic RT (43). The incidence of IF seems to be higher than expected, although there are many discrepancies in the various study (5,(10)(11)(12)(13)(14)(44)(45)(46), probably due to the differences in the follow-up, as the choice of imaging may increase the detection of asymptomatic IFs. One study reported 89% of patients had findings compatible with IF after pelvic RT using magnetic resonance imaging (47), while another study reported 34% using bone scintigraphy (48).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

3D bone texture analysis as a potential predictor of radiation-induced insufficiency fractures

Nardone¹,

Tini²,

Croci³

et al. 2018

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

Background: The aim of our work is to assess the potential role of texture analysis (TA), applied to computed tomography (CT) simulation scans, in relation to the development of insufficiency fractures (IFs) in patients undergoing radiation therapy (RT) for pelvic malignancies. Methods:We analyzed patients undergoing pelvic RT from Jan-2010 to Dec-2016, 31 of whom had developed IFs of the pelvis. We analyzed CT simulation scans using LifeX Software © , and in particular we selected three regions of interest (ROI): L5 body, the sacrum and both the femoral heads. The ROI were automatically contoured using the treatment planning software Raystation © . TA parameters included parameters from the gray-level histogram, indices from sphericity and from the matrix of GLCM (gray level co-occurrence matrix). The IFs patients were matched (1:1 ratio) with control patients who had not developed IFs, and were matched for age, sex, type of tumor, menopausal status, RT dose and use of chemotherapy. Univariate and multivariate analyses (logistic regression) were used for statistical analysis.Results: Significant TA parameters on univariate analysis included both parameters from the histogram distribution, as well from the matrix of GLCM. On logistic regression analysis the significant parameters Conclusions: In our experience, 3D-bone CT TA can be used to stratify the risk of the patients to develop radiation-induced IFs. A prospective study will be conducted to validate these findings.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Recently, radiation therapy (RT) has been recognized as a risk factor for IFs (5) in many malignancies (6)(7)(8)(9)(10), ranging from 9% to 11.2% in rectal (11), 8.2% to 45.2% in cervical (12)(13)(14), and up to 6.8% (10) in prostate cancer,…”

Section: Introductionmentioning

confidence: 99%

3D bone texture analysis as a potential predictor of radiation-induced insufficiency fractures

Nardone¹,

Tini²,

Croci³

et al. 2018

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

show abstract

“…Yapılan araştırmalarda prostat kanserine bağlı radyoterapi sonrası 5 yıllık takiplerde semptomatik PYK sıklığı %6,8 oranında bulunmuştur. Radyoterapi sonrası PYK gelişme süresi ise ortalama 20 ay bulunmuştur (2). Ancak bizim olgumuzda 60 ay gibi daha uzun sürede çıkmıştır.…”

Section: Discussionunclassified

“…Pelvik bölgeye uygulanan radyoterapinin başlıca komplikasyonları; femur başında avasküler nekroz (AVN), pelvik kuşakta yetersizlik kırığı oluşturmasıdır. Radyasyon ile indüklenen kemikteki komplikasyonlar; vasküler tıkanıklık, ödem, hücreselliğin kaybı, kanama alanları, fokal kemik iliği değişiklikleri, osteoliz, yetersizlik kırıkları, AVN ve radyasyonla indüklenen neoplazmlar olarak sayılabilir (2). Bu komplikasyonlar özellikle lokomotor sistemde ağrı, hareket zorluğu ve fonksiyon kaybı ile hastanın günlük yaşam aktivitelerini bozabilir.…”

Section: Introductionunclassified

Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case Report

Sarı¹,

Örnek²,

Sucuoğlu³

et al. 2016

Tod

View full text Add to dashboard Cite

SummaryProstate cancer is one of the most common malignancies in men. Pelvic radiotherapy is commonly used in both radical and palliative treatment for prostate cancer. Radiation-induced adverse effects might be seen on adjacent healthy tissues (such as vessels, bones and soft tissues) with the exception of targeted area. Particularly several years after radiotherapy, low back and hip pain may occur due to bone edema, necrosis or fractures. In these cases, whether complaints due to the degenerative, metastatic or radiotherapy complications must be examined and appropriate treatment should be arranged. For this purpose, we present our elderly patient who received radiotherapy for prostate cancer, and thereafter, developed bilateral avascular hip necrosis and pelvic insufficiency fractures. Keywords: Prostate cancer, radiotherapy, pelvic, insufficiency fracture, avascular necrosis Prostat Kanseri Radyoterapisi Sonrası Gelişen Femur Başı Avasküler Nekrozu ve Pelvik Yetersizlik Kırığı Olgusu Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case ReportProstat kanseri, erkeklerde en sık görülen malignitelerden biridir. Pelvik radyoterapi, radikal veya palyatif prostat kanseri tedavisinde yaygın olarak kullanılmaktadır. Radyoterapi, hedef kanser bölgesi dışındaki komşu sağlam dokularda (damar, sinir, kemik gibi) komplikasyonlar meydana getirebilir. Özellikle radyoterapiden yıllar sonra ortaya çıkabilen kemiklerde ödem, nekroz veya kırıklara bağlı bel ve kalça ağrıları meydana gelebilir. Bu olgularda şikayetlerin dejeneratif, metastatik veya radyoterapi komplikasyonuna mı bağlı olduğu tetkik edilmeli ve tedavi buna göre düzenlenmelidir. Biz de bu amaçla, prostat kanserinde pelvik radyoterapi uygulanan ve buna bağlı bilateral kalça avasküler nekrozu ve pelvik yetersizlik kırıkları gelişen yaşlı erkek hastamızı sunuyoruz.

show abstract

“…8 ), and whilst the association is well documented in gynaecological and colorectal studies with a 5-year incidence of 8.2-19.7 %, there is a paucity of data in prostate cancer (Oh et al 2008 ). The data available for prostate cancer suggests that insuffi ciency fractures are rare in this group with a 5-year incidence of 6.8 % (Igdem et al 2010 ). Sacral fractures are most common followed by pubic rami and femoral neck.…”

Section: Bonesmentioning

confidence: 99%

Female Pelvis: Genital Organs

Forstner

Cunha²

2015

Imaging of Complications and Toxicity Following Tumor Therapy

View full text Add to dashboard Cite

Medical Radiology-Diagnostic Imaging is a unique series that aims to document the most innovative technologies in all fi elds within diagnostic imaging and interventional radiology, thereby informing the physician in practice of the latest advances in diagnostic imaging and percutaneous imageguided minimally invasive procedures. Th e contents are intended to cover all organs, and all modern imaging techniques and image-guided treatment modalities, with special emphasis on applications in clinical practice. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. Medical Radiology -Radiation Oncology is a unique series that aims to document the most innovative technologies in all fi elds within radiology, thereby informing the physician in practice of the latest advances in diagnostic and treatment techniques. Th e contents range from contemporary statements relating to management for various disease sites to explanations of the newest techniques for tumor identifi cation and of mechanisms for the enhancement of radiation eff ects, with the emphasis on maximizing cure and minimizing complications. Each volume is a comprehensive reference book on a topical theme, and the editors are always experts of high international standing. Contributions are included from both clinicians and researchers, ensuring wide appeal. This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. AbstractA precise knowledge of antineoplastic drugs is an indispensable basis for the care of patients with cancer. The mechanisms of action and resistance, cross-resistance patterns, pharmacodynamics and pharmacokinetics, pharmacological interaction, and last but not least potential adverse effects should be part of this knowledge. As contemporary cancer care requires interdisciplinary and multiprofessional structures, the radiologist is an important a...

show abstract

Insufficiency Fractures After Pelvic Radiotherapy in Patients With Prostate Cancer

Cited by 68 publications

References 28 publications

3D bone texture analysis as a potential predictor of radiation-induced insufficiency fractures

3D bone texture analysis as a potential predictor of radiation-induced insufficiency fractures

Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case Report

Female Pelvis: Genital Organs

Contact Info

Product

Resources

About