Pelvic Insufficiency Fractures in Cervical Cancer After Radiation Therapy: A Meta-Analysis and Review
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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.
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.
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.
Haque M, Hossen M BMC Womens Health. 2024; 24(1):306.
PMID: 38783273 PMC: 11112889. DOI: 10.1186/s12905-024-03099-8.
Malikova H, Nadova K, Reginacova K, Kremenova K, Rob L Diagnostics (Basel). 2024; 14(8).
PMID: 38667456 PMC: 11049002. DOI: 10.3390/diagnostics14080810.
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.