ArticleClinical and translational radiation oncology2019
Pelvic insufficiency fractures, dose volume parameters and plan optimization after radiotherapy for rectal cancer.
Article in Clinical and translational radiation oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Evaluating the Effectiveness of Proton Beam Therapy Compared to Conventional Radiotherapy in Non-Metastatic Rectal Cancer: A Systematic Review of Clinical Outcomes.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Effect of Pelvic External Beam Radiation Therapy on Bone Mineral Density: A Secondary Analysis of a Phase 3 Randomized Controlled Trial.International journal of radiation oncology, biology, physics · 2024Trial
- Optimising chemoradiotherapy in anal cancer.ESMO gastrointestinal oncology · 2026Review
- Sacral Fractures After Short-Course Radiation Therapy for Rectal Cancer.Advances in radiation oncology · 2026Article
- Risk-Adapted Selective Elective Nodal Irradiation in the Total Neoadjuvant Therapy Era for Rectal Cancer.Medicina (Kaunas, Lithuania) · 2026Review
- A single institution retrospective study of pelvic insufficiency fractures following curative-intent pelvic intensity-modulated radiation therapy for gynecologic, gastrointestinal, and genitourinary cancers.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Case Report: Is the isolated bone change in advanced colorectal cancer necessarily malignant metastasis?Frontiers in oncology · 2025Article
- Particle therapy in gastrointestinal cancer-a narrative review.Journal of gastrointestinal oncology · 2024Review
- Radiation-Related Fractures after Radical Radiotherapy for Cervical and Endometrial Cancers: Are There Any Differences?Diagnostics (Basel, Switzerland) · 2024Article
- A prospective study of changes in bone health in adult cancer patients treated with pelvic radiotherapy.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2024Article
- Short-course preoperative radiotherapy increases pelvic fracture risk in rectal cancer.Clinical and translational radiation oncology · 2023Article
- Preoperative short-course radiation therapy with PROtons compared to photons in high-risk RECTal cancer (PRORECT): Initial dosimetric experience.Clinical and translational radiation oncology · 2023Article
- Proton Therapy in the Management of Luminal Gastrointestinal Cancers: Esophagus, Stomach, and Anorectum.Cancers · 2022Review
- Pelvic Insufficiency Fractures and Bone Pain after Radiation Therapy for Anal Cancer: Relation to Pelvic Bone Dose-Volume Parameters.Advances in radiation oncologyArticle
- Should Postoperative Radiation for Long Bone Metastases Cover Part or All of the Orthopedic Hardware? Results of a Large Retrospective Analysis.Advances in radiation oncologyArticle
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pelvic insufficiency fractures (PIF) is a known but under-acknowledged late effect of pelvic radiotherapy. In rectal cancer, studies describing incidence of PIF and relation to dose volume relationships are lacking. The aim of this study was (i) to analyse dose volume histograms (DVH) from pelvic bones in patients with and without PIF, and (ii) to determine bone sparing capacity of 2 and 3 arc volumetric arc therapy (VMAT), intensity modulated radiotherapy (IMRT) and proton beam therapy (PBT), in rectal cancer patients treated with chemoradiotherapy (CRT). MATERIAL AND
methodsPatients treated with CRT for primary rectal cancer underwent a 3-year pelvic MRI for identification of PIFs. Bone structures were retrospectively delineated, and DVHs were re-calculated. Comparative planning was done with 2 (original) and 3 arc VMAT, fixed field IMRT and PBT plans.
results27 patients (18 men, mean age 64 years) were included and PIFs were identified in 9 (33%), most (n = 6) had multiple fracture sites. In general, patients with PIFs received higher doses to pelvic bones, and V30 Gy to the sacroiliac joint was non-significantly higher in patients with PIF 68.5% (60.1-69.3 IQR) vs. 56% (54.1-66.6 IQR),
conclusionsPatients, treated with VMAT based CRT for rectal cancer, have high rates of PIFs after 3 years. Patients with PIFs tended to have received higher doses to sacroiliac joints. Comparative planning demonstrated most pronounced bone sparing capacity of 3 arc VMAT and with PBT having the potential to further lower doses. These results should be validated in larger and preferably prospective cohorts.
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