Pelvic insufficiency fracture after pelvic irradiation in uterine cervix cancer
Pelvic insufficiency fracture after pelvic irradiation in uterine cervix cancer
复制标题
DOI：
10.1006/gyno.2002.6756
复制
发表时间：
2002-09-01
影响因子：
4.7
通讯作者：
Ahn, YC
中科院分区：
文献类型：
--
作者：
Huh, SJ;Kim, B;Ahn, YC
目标。骨盆功能不全骨折（IF）是众所周知的，但不常见，并经常被误解的后遗症。方法：在1994年至2000年期间接受宫颈癌治疗的463名患者进行了临床检查。所有患者均接受了10或15 MV光子治疗，辅助目的为28次50.4-55.8 Gy (n = 235)，此外还有6次高剂量近距离治疗24 Gy （n = 228）。中位随访时间为38个月。8例患者（8/463,1.7%）在治疗后7-19个月（中位，12个月）发生盆腔IF。其中，7名患者（7/228,3.1%）接受治疗意图，1名患者（1/235,0.4%）接受辅助治疗意图。所有患者均绝经后，主诉有中度至重度盆腔疼痛，经保守治疗1-11个月后消退。其中2例还伴有放射性直肠炎。在宫颈癌放疗后出现盆腔疼痛的妇女中，骨破坏和骨折可能表明晚期放疗效应，而不是骨转移。IF在治愈治疗组较术后辅助治疗组多见。(C) 2002 Elsevier Science （USA）。
Objectives. Pelvic insufficiency fractures (IF) are well known but uncommon and are frequently misinterpreted sequelae. The clinical features were investigated.Methods. Four hundred sixty-three patients, who were treated between 1994 and 2000 for uterine cervix cancer, were clinically examined. All patients had been treated with 10 or 15 MV photons, with 50.4-55.8 Gy in 28 fractions with adjuvant intent (n = 235) in addition to high-dose-rate brachytherapy 24 Gy in 6 fractions for curative treatment (n = 228). The median follow-up was 38 months.Results. Eight patients (8/463, 1.7%) developed pelvic IF 7-19 months (median, 12 months) after the treatment. Among these, seven patients (7/228, 3.1%) were treated with curative intent and one (1/235, 0.4%) was treated with adjuvant intent. All patients were postmenopausal and complained of moderate to severe pelvic pain, which resolved after 1-11 months with conservative therapy in all patients. Two of these patients also had radiation proctitis.Conclusion. In women who present with pelvic pain after radiotherapy for cervical cancer, bony destruction and fractures may be indicative of a late radiation effect rather than osseous metastasis. IF are more common in the curative treatment group than in the postoperative adjuvant group. (C) 2002 Elsevier Science (USA).