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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Tatar, Zuzana Soubrier, Martin Dillies, Anne Françoise Verrelle, Pierre Boisgard, Stéphane Lapeyre, Michel |
| Abstract | Background Radiotherapy for long bone metastases (RTLB) can be complicated by fractures, which considerably increase morbidity and mortality. The aim of this study was to analyze the risk factors for impending fractures following radiotherapy for long bone metastases (RTLB) using CT scan-based virtual simulation. Methods Forty-seven (47) patients were treated with RTLB (18 lung, 11 breast, 10 prostate and 8 other cancers) for a period of 18 months. Two doctors analyzed the CT images prior to radiation therapy. The impending fractures were then monitored and the correlation between bone scan parameters and fracture occurrence was analyzed. Results The male gender ratio was 0.57 and the mean age 62.8 (33–93) years. The average size of the metastatic lesions was 32 (8–87) x 2 (6–81) x 52 (7–408) mm with cortical involvement (CI) in 66% of cases. The site was in the upper third of the bone in 92% of cases (28 femoral, 17 humeral and two tibial). Ten fractures occurred: two during RTLB, seven after one month and one after 6.6 months. The fractured lesions measured 48 (17–87) x 34 (12–66) x 76 (38–408) mm. The predictive parameters for fracture were osteolytic (39% vs. 10%; p = 0.02) and permeative lesions (42% vs. 0%; p < 0.0005), a Mirels score ≥9 (42% vs. 0%; p < 0.0005), circumferential CI ≥30% (71% vs. 0%, p < 0.00001), CI ≥45 mm in height (67% vs. 0%, p < 0.00001) and CI in thickness =100% (40% vs. 0%; p = 0.0008). In the multivariate analysis, circumferential CI ≥30% was the only predictive parameter for fracture (p = 0.00035; OR = 62; CI 95%: 6.5-595). Overall survival was 91% and 40% at one month and twelve months respectively. Conclusions Prophylactic primary fixation surgery should always be considered when the circumferential CI ≥30%. |
| Related Links | https://ro-journal.biomedcentral.com/counter/pdf/10.1186/s13014-014-0227-1.pdf |
| Ending Page | 10 |
| Page Count | 10 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| DOI | 10.1186/s13014-014-0227-1 |
| Journal | Radiation Oncology |
| Issue Number | 1 |
| Volume Number | 9 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2014-10-16 |
| Access Restriction | Open |
| Subject Keyword | Cancer Research Oncology Radiotherapy Imaging Radiology Long bone metastases Fractures |
| Content Type | Text |
| Resource Type | Article |
| Subject | Radiology, Nuclear Medicine and Imaging Oncology |
| Journal Impact Factor | 3.3/2023 |
| 5-Year Journal Impact Factor | 3.6/2023 |
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