| 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].Chinese Journal of Radiological Medicine and Protection,2017,37(3):193-198 |
| The incidence and risk factors of pelvic insufficiency fracture in patients with cervical cancer after intensity-modulated radiotherapy |
| Received:October 13, 2016 |
| DOI：10.3760/cma.j.issn.0254-5098.2017.03.006 |
| KeyWords:Cervical cancer Intensity modulated radiotherapy Pelvic insufficiency fractures |
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| Abstract:: |
| 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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