» Articles » PMID: 33622908

Pelvic Insufficiency Fractures in Cervical Cancer After Radiation Therapy: A Meta-Analysis and Review

Overview
Journal In Vivo
Specialty Oncology
Date 2021 Feb 24
PMID 33622908
Citations 10
Authors
Affiliations
Soon will be listed here.
Abstract

Aim: The aim of the study was to estimate the prevalence of pelvic insufficiency fractures (PIFs) after radiation therapy (RT) in patients with cervical cancer.

Patients And Methods: A total of 3,633 patients from 15 cohort studies were included. Proportion meta-analysis was performed to estimate prevalence and subgroup analysis was performed according to imaging modalities for diagnosis of PIF. For continuous variables (age and length of follow-up), meta-regression analysis was performed.

Results: Pooled prevalence estimate of PIF was 14% (95% CI=10-19). Incidence of PIF was higher in studies that used MRI as a diagnostic tool (17%, 95% CI=12-22) than non-MRI (8%, 95% CI=2-14). In meta-regression, we found a significant association of prevalence of PIF with age (p=0.021) but not with length of follow-up (p=0.118).

Conclusion: PIF after RT in patients with cervical cancer is not rare. Physicians need to pay attention to PIFs, especially in patients with high-risk factors for osteoporotic fracture.

Citing Articles

Insufficiency fractures in patients with sacral chordoma treated with high-dose radiation therapy with and without resection.

Miladinovic V, van der Wal R, Appelman-Dijkstra N, Navas Canete A, Peul W, Bloem J BJR Open. 2025; 7(1):tzaf001.

PMID: 39885921 PMC: 11780842. DOI: 10.1093/bjro/tzaf001.


Prevention and management of radiotherapy-related toxicities in gynecological malignancies. Position paper on behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology).

Perrucci E, Macchia G, Cerrotta A, Andrulli A, Autorino R, Barcellini A Radiol Med. 2024; 129(9):1329-1351.

PMID: 39198369 PMC: 11379782. DOI: 10.1007/s11547-024-01844-5.


Insights into pelvic insufficiency fracture following pelvic radiotherapy for cervical cancer: a comparative review.

Haque M, Hossen M BMC Womens Health. 2024; 24(1):306.

PMID: 38783273 PMC: 11112889. DOI: 10.1186/s12905-024-03099-8.


Radiation-Related Fractures after Radical Radiotherapy for Cervical and Endometrial Cancers: Are There Any Differences?.

Malikova H, Nadova K, Reginacova K, Kremenova K, Rob L Diagnostics (Basel). 2024; 14(8).

PMID: 38667456 PMC: 11049002. DOI: 10.3390/diagnostics14080810.


Musculoskeletal Pitfalls on Molecular Imaging Studies of Oncologic Patients: How to Stay Out of Trouble.

Sarna B, Subhawong T, Sfakianaki E, Wang R, Christodoulou-Vega A, Cardoso F Tomography. 2024; 10(3):378-399.

PMID: 38535772 PMC: 10975531. DOI: 10.3390/tomography10030030.


References
1.
Shih K, Folkert M, Kollmeier M, Abu-Rustum N, Sonoda Y, Leitao Jr M . Pelvic insufficiency fractures in patients with cervical and endometrial cancer treated with postoperative pelvic radiation. Gynecol Oncol. 2012; 128(3):540-3. DOI: 10.1016/j.ygyno.2012.12.021. View

2.
Small Jr W, Kachnic L . Postradiotherapy pelvic fractures: cause for concern or opportunity for future research?. JAMA. 2005; 294(20):2635-7. DOI: 10.1001/jama.294.20.2635. View

3.
Zhang L, He Q, Jiang M, Zhang B, Zhong X, Zhang R . Diagnosis of Insufficiency Fracture After Radiotherapy in Patients With Cervical Cancer: Contribution of Technetium Tc 99m-Labeled Methylene Diphosphonate Single-Photon Emission Computed Tomography/Computed Tomography. Int J Gynecol Cancer. 2018; 28(7):1369-1376. DOI: 10.1097/IGC.0000000000001337. View

4.
Bliss P, Parsons C, Blake P . Incidence and possible aetiological factors in the development of pelvic insufficiency fractures following radical radiotherapy. Br J Radiol. 1996; 69(822):548-54. DOI: 10.1259/0007-1285-69-822-548. View

5.
Oh B, Heo Y, Yi J, Kim T, Lee J . Atypical Fracture of the Proximal Shaft of the Ulna Associated with Prolonged Bisphosphonate Therapy. Clin Orthop Surg. 2018; 10(3):389-392. PMC: 6107824. DOI: 10.4055/cios.2018.10.3.389. View