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An easy way to determine bone mineral density and predict pelvic insufficiency fractures in patients treated with radiotherapy for cervical cancer.

Authors :
Kurrumeli D
Oechsner M
Weidenbächer B
Brambs C
Löffler M
Combs SE
Borm K
Duma MN
Source :
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] [Strahlenther Onkol] 2021 Jun; Vol. 197 (6), pp. 487-493. Date of Electronic Publication: 2020 Oct 06.
Publication Year :
2021

Abstract

Purpose: The aim of this study was to investigate whether bone mineral density (BMD) as measured in planning computed tomographies (CTs) by a new method is a risk factor for pelvic insufficiency fractures (PIF) after radio(chemo)therapy (R(C)T) for cervical cancer.<br />Methods: 62 patients with cervical cancer who received definitive or adjuvant radio(chemo)therapy between 2013 and 2017 were reviewed. The PIF were detected on follow-up magntic resonance imaging (MRI). The MRI of the PIF patients was registered to the planning CT and the PIF contoured. On the contralateral side of the fracture, a mirrored structure of the fracture was generated (mPIF). For the whole sacral bone, three lumbar vertebrae, the first and second sacral vertebrae, and the PIF, we analyzed the BMD (mg/cm <superscript>3</superscript> ), V50Gy, Dmean, and Dmax.<br />Results: Out of 62 patients, 6 (9.7%) had a fracture. Two out of the 6 patients had a bilateral fracture with only one of them being symptomatic. PIF patients showed a significantly lower BMD in the sacral and the lumbar vertebrae (p < 0.05). The BMD of the contoured PIF, however, when comparing to the mPIF, did not reach significance (p < 0.49). The difference of the V50Gy of the sacrum in the PIF group compared to the other (OTH) patients, i.e. those without PIF, did not reach significance.<br />Conclusion: The dose does not seem to have a relevant impact on the incidence of PIF in our patients. One of the predisposing factors for developing PIF after radiotherapy seems to be the low BMD. We presented an easy method to assess the BMD in planning CTs.

Details

Language :
English
ISSN :
1439-099X
Volume :
197
Issue :
6
Database :
MEDLINE
Journal :
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
Publication Type :
Academic Journal
Accession number :
33025097
Full Text :
https://doi.org/10.1007/s00066-020-01690-0