| 杨洪娟,书阿克·努尔江,谢丛华.宫颈癌调强放疗后骨盆衰竭骨折的发生率及影响因素分析[J].中华放射医学与防护杂志,2017,37(3):193-198.Yang Hongjuan,Shuake·Nuerjiang,Xie Conghua.The incidence and risk factors of pelvic insufficiency fracture in patients with cervical cancer after intensity-modulated radiotherapy[J].Chin J Radiol Med Prot,2017,37(3):193-198 |
| 宫颈癌调强放疗后骨盆衰竭骨折的发生率及影响因素分析 |
| The incidence and risk factors of pelvic insufficiency fracture in patients with cervical cancer after intensity-modulated radiotherapy |
| 投稿时间：2016-10-13 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.03.006 |
| 中文关键词: 宫颈癌 调强放疗 衰竭骨折 |
| 英文关键词:Cervical cancer Intensity modulated radiotherapy Pelvic insufficiency fractures |
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| 中文摘要: |
| 目的 探讨宫颈癌盆腔调强放疗后患者骨盆衰竭骨折（PIF）的发生率及影响因素。方法 收集2013年11月至2015年12月在本院行盆腔调强放疗的104例宫颈癌患者，回顾性分析随访过程中骨盆衰竭骨折的发生情况及其影响因素。结果 104例患者中，16例（31个部位）患者发生了骨盆衰竭骨折，发生率为15.4%；其中多发骨折患者10例（62.5%）。有症状的患者5例（31%），经休息或止痛治疗后症状可缓解。骨折发生的时间是放疗结束后1~16个月（平均6.5个月）。发生的部位分别是骶骨16例（51.6%）、骶髂关节7例（22.6%）、髂骨6例（19.4%）、股骨头1例（3.2%）及耻骨1例（3.2%）。单因素和多因素分析显示，绝经后状态和低体重（≤ 55 kg）是宫颈癌盆腔调强放疗后骨盆衰竭骨折的危险因素（P<0.05）。亚组分析发现，对宫颈癌术后辅助调强放疗患者，绝经后状态是盆腔调强放疗后衰竭骨折的危险因素（P<0.05）。结论 绝经后状态和低体重（≤ 55 kg）是影响宫颈癌患者盆腔调强放疗后衰竭骨折发生的重要危险因素。 |
| 英文摘要: |
| Objective To analyze the incidence and risk factors of pelvic insufficiency fractures (PIF) in patients with cervical cancer who received pelvic intensity-modulated radiotherapy. Methods This study a retrospective review of all patients was performed with cervical cancer who received pelvic intensity-modulated radiotherapy at our institution from November 2013 to December 2015, and the incidence and risk factors of insufficiency fractures were analyzed. Results Among the 104 patients, 16(with a total of 31 lesions) were diagnosed with pelvic insufficiency fracture. The occurrence rate of pelvic insufficiency was 15.4%. Ten patients (62.5%) had multiple fractures and five patients (31%) complained of pain. All patients' pain was relieved by rest or analgesic drugs. Insufficiency fractures were detected at a median of 6.5 months (range 1-16) from radiotherapy completion. The distribution of PIFs was followed:sacral had 16 cases (51.6%), sacroiliac joint had 7 cases (22.6%), iliac had 6 cases(19.4%), femoral head had 1 case (3.2%) and pubis had 1 case(3.2%). Univariate analysis and multiple analysis showed that postmenopausal status and low body weight (≤ 55 kg) were thought to be risk factors for PIF(P<0.05). Subgroup analysis also confirmed that postmenopausal status was a risk factor for PIF(P<0.05) in postoperative cervical cancer patients after pelvic intensity-modulated radiation therapy. Conclusions Cervical cancer patients with menopausal status and low body weight (≤ 55 kg) are at some risk for the development of PIF after pelvic intensity-modulated radiotherapy. |
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