Abstract
PurposeFractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones.Materials and MethodsFor 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures.ResultsPosttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P < 0.05–0.01 across sites, except for the ilium and the ischium). Although DVH parameters were also significantly associated with fractures in univariate analysis, only CT densities were significantly associated with fractures in multivariate analysis.ConclusionPretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.
Highlights
Definitive radiotherapy for uterine cervical cancer is a standard treatment at Fédération Internationale de Gynécologie et d’Obstétrique [FIGO] 2008 stage IB toIVA, and a Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903‐0215, JapanHealth Information Management Center, University of the Ryukyus Hospital, 207 Uehara, Nishihara, Okinawa 903‐0215, JapanRadiation Therapy Center, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa 904‐2293, JapanDepartment of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903‐0215, Japan common treatment option for elderly women
Pretreatment computed tomography (CT) densities of spinal and pelvic bones had a significant impact on the risk of posttreatment fractures
Several factors have been identified that have a significant effect on fractures of the lumbar spine and pelvic bones
Summary
As CT scans only evaluate parts of the bones, they may be different depending on the location of the measurement areas
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