Radiotherapy induced hip joint avascular necrosis—Two cases report

Michalecki, Łukasz; Gabryś, Dorota; Kulik, R.; Wydmański, Jerzy; Trela, K.

doi:10.1016/j.rpor.2011.04.004

Cited by 19 publications

(13 citation statements)

References 15 publications

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“…AVN constitutes a very difficult diagnostic problem. Its slow progression in long-term cancer survivors means that symptoms often appear many years after RT; thus, patients do not associate them with this past treatment (1,5). In our case, the AVN symptoms appeared immediately after the first round of RT, and to the best of our knowledge, this is the first case of its kind in the literature.…”

Section: Case Reportmentioning

confidence: 62%

“…Nowadays, radiotherapy (RT) is an integral part of the therapeutic program for cancer patients. One of the most severe, dose-dependent, and challenging long-term complications related to RT is osteonecrosis or avascular necrosis (AVN) (1,2). It generally presents after radiation exposure in the same extremity as the irradiated area, and the humeral head is the second most common affected region (3).…”

Section: Introductionmentioning

confidence: 99%

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Contralateral Humerus Avascular Necrosis Diagnosed Immediately After Radiotherapy in a Patient with Breast Cancer

Analan¹

2016

West Indian Med J

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Radiotherapy (RT) is an important component of treatment for malignant tumors, and avascular necrosis (AVN), which is often associated with high morbidity and disability, frequently accompanies this type of therapy. It generally develops in the same extremity with the treated region and may continue long after the treatment is completed. Early identification of AVN has the potential to reduce morbidity and improve the patient's quality of life. Herein, we present a case of contralateral humerus avascular necrosis diagnosed immediately after the first round of RT in a patient with breast cancer.

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Section: Case Reportmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Contralateral Humerus Avascular Necrosis Diagnosed Immediately After Radiotherapy in a Patient with Breast Cancer

Analan¹

2016

West Indian Med J

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“…Furthermore, constraints for bladder of V 65Gy < 50%, V 70Gy < 35%, V 75Gy < 25% and V 80Gy < 15% are reported to limit Grade ≥ 3 bladder toxicity. 41,43,44 Michalecki et al 45 reported that the probability of radiation induced changes in bone (osteitis, fracture) depends on many factors, including the dose per fraction, total dose, dose intensity and irradiated volume. Tolerance doses such as TD 5/5 , TD 50/5 , which represent the dose of radiation that could cause no more than 5% and 50% severe complication rate within 5 years after irradiation, range from 20 to 30 Gy and 65 to 70 Gy for single and fractionated dose, respectively.…”

Section: Oar Dose Evaluationmentioning

confidence: 99%

Dosimetric evaluation of whole-pelvis radiation therapy of prostate cancers: clinical experience

et al. 2020

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Background: The standard treatment modalities for prostate cancer include surgery, chemotherapy, hormonal therapy and radiation therapy or any combination depending on the stage of the tumour. Radiation therapy is a common and effective treatment modality for low-intermediate-risk patients with localised prostate cancer, to treat the intact prostate and seminal vesicles or prostate bed post prostatectomy. However, for high-risk patients with lymph node involvement, treatment with radiation will usually include treatment of the whole pelvis to cover the prostate and seminal vesicles or prostate bed and the pelvic lymph nodes followed by a boost delivery dose to the prostate and seminal vesicles or prostate bed. Materials and Methods: We retrospectively analysed the treatment plans for 179 prostate cancer patients treated at the cancer centre with the volumetric-modulated arc therapy (VMAT) technique via RapidArc using 6 MV photon beam. Patients were either treated with a total prescription dose of 78 Gy in 39 fractions for patients with intact prostate or 66 Gy in 33 fractions for post prostatectomy patients. Results: There were 114 (64%) patients treated with 78 Gy/39 and 65 (36%) treated with 66 Gy/34. The mean homogeneity index (HI), conformity index (CI) and uniformity index (UI) for the PTV-primary of patients treated with 78 Gy are 0.06 ± 0.01, 1.04 ± 0.01 and 0.99 ± 0.01, respectively, and the corresponding mean values for patients treated with 66 Gy are 0.06 ± 0.02, 1.05 ± 0.01 and 0.99 ± 0.01, respectively. The mean PTV-primary V95%, V100% and V105% are 99.5 ± 0.5%, 78.8 ± 12.2% and 0.1 ± 0.5%, respectively, for patients treated with 78 Gy and 99.3 ± 0.9%, 78.1 ± 10.6% and 0.1 ± 0.4%, respectively, for patients treated with 66 Gy. The rectal V50Gy, V65Gy, V66.6Gy, V70Gy, V75Gy and V80Gy are 26.8 ± 9.1%, 14.2 ± 5.3%, 13.1 ± 5.0%, 10.8 ± 4.3%, 6.9 ± 3.1% and 0.1 ± 0.1%, respectively, for patients treated with 78 Gy and 33.7 ± 8.4%, 14.1 ± 4.5%, 6.7 ± 4.5%, 0.0 ± 0.2%, 0.0% and 0.0%, respectively, for patients treated with 66 Gy. Conclusion: The use of VMAT technique for radiation therapy of high-risk prostate cancer patients is an efficient and reliable method for achieving superior dose conformity, uniformity and homogeneity to the PTV and minimal doses to the organs at risk. Results from this study provide the basis for the development and implementation of consistent treatment criteria in radiotherapy programs, have the potential to establish an evaluation process to define a consistent, standardised and transparent treatment path for all patients that reduces significant variations in the acceptability of treatment plans and potentially improve patient standard of care.

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“…Pelvic insufficiency fractures (PIFs) are the most commonly discussed chronic bone toxicity of pelvic radiation [67, 68]; however, osteoradionecrosis and osteomyelitis are rarer, late complications of pelvic radiation [69, 70]. PIFs following pelvic radiation most often occur in the sacrum, pubic symphysis, or pubic rami [67, 71, 72].…”

Section: Management Of Chronic Toxicitiesmentioning

confidence: 99%

A multi-disciplinary model of survivorship care following definitive chemoradiation for anal cancer

et al. 2019

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Following definitive chemoradiation for anal squamous cell carcinoma (ASCC), patients face a variety of chronic issues including: bowel dysfunction, accelerated bone loss, sexual dysfunction, and psychosocial distress. The increasing incidence of this disease, high cure rates, and significant long-term sequelae warrant increased focus on optimal survivorship care following definitive chemoradiation. In order to establish our survivorship care model for ASCC patients, a multi-disciplinary team of experts performed a comprehensive literature review and summarized best practices for the multi-disciplinary management of this unique patient population. We reviewed principle domains of our survivorship approach: (1) management of chronic toxicities; (2) sexual health; (3) HIV management in affected patients; (4) psychosocial wellbeing; and (5) surveillance for disease recurrence and survivorship care delivery. We provide recommendations for the optimization of survivorship care for ASCC patients can through a multi-disciplinary approach that supports physical and psychological wellness.

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Radiotherapy induced hip joint avascular necrosis—Two cases report

Cited by 19 publications

References 15 publications

Contralateral Humerus Avascular Necrosis Diagnosed Immediately After Radiotherapy in a Patient with Breast Cancer

Contralateral Humerus Avascular Necrosis Diagnosed Immediately After Radiotherapy in a Patient with Breast Cancer

Dosimetric evaluation of whole-pelvis radiation therapy of prostate cancers: clinical experience

A multi-disciplinary model of survivorship care following definitive chemoradiation for anal cancer

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