Radiation Oncology/Toxicity/Bone

Bone Toxicity

This page concerns damage to bones, such as femoral head fracture and pelvic insufficiency fractures. For bone marrow toxicity, see Toxicity/Bone marrow

• Also please see Toxicity/Pelvis

Pelvic Insufficiency Fractures

Also: Radiation Osteitis

Gynecologic Cancers

• MD Anderson; 2010 (2001 - 2006) PMID 20052724 -- "Pelvic fractures after radiotherapy for cervical cancer: implications for survivors." (Schmeler KM, Cancer. 2010 Feb 1;116(3):625-30. doi: 10.1002/cncr.24811.)
  • Retrospective. 300 women, cervical cancer, curative-intent radiation, with at least 1 post-treatment CT/MRI
  • Outcome: pelvic fractures 10%. Site included sacrum (83%), sacrum and pubis (10%), iliac crest (3%), sacrum and acetabulum (3%). Symptomatic 13%, typically pain. Median time 14.1 month to detection; 38% within 1 year, 83% within 2 years of completing RT. Fractures more common in postmenopausal (62% vs 37%, SS) and lower BMI (SS) women
  • Conclusion: Pelvic fractures in substantial proportion of women after RT for cervical cancer. Bone mineral density screening and pharmacologic intervention should be considered in these women

• U. Kentucky; 1994 PMID 8192113 -- "Radiation osteitis and insufficiency fractures after pelvic irradiation for gynecologic malignancies." (Fu AL, Am J Clin Oncol. 1994 Jun;17(3):248-54.)
  • 12 pts treated for endometrial or cervical cancer with RT-related bone damage.

Prostate Cancer

• Turkey; 2010 (1998-2007) PMID 19879066 -- "Insufficiency fractures after pelvic radiotherapy in patients with prostate cancer." (Igdem S, Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):818-23.)
  • 134 pts treated with pelvic RT for prostate cancer. 8 pts developed symptomatic insufficiency fractures at a median f/u of 68 months. 5-yr incidence 6.8%.
  • Conclusion: Pelvic IF is a rare complication of pelvic radiotherapy in prostate cancer.