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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 6/2021

Open Access 01-06-2021 | Magnetic Resonance Imaging | Original Article

An easy way to determine bone mineral density and predict pelvic insufficiency fractures in patients treated with radiotherapy for cervical cancer

Authors: Drilon Kurrumeli, Markus Oechsner, Bianca Weidenbächer, Christine Brambs, Maximilian Löffler, Stephanie Elisabeth Combs, Kai Borm, Marciana Nona Duma

Published in: Strahlentherapie und Onkologie | Issue 6/2021

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Abstract

Purpose

The aim of this study was to investigate whether bone mineral density (BMD) as measured in planning computed tomographies (CTs) by a new method is a risk factor for pelvic insufficiency fractures (PIF) after radio(chemo)therapy (R(C)T) for cervical cancer.

Methods

62 patients with cervical cancer who received definitive or adjuvant radio(chemo)therapy between 2013 and 2017 were reviewed. The PIF were detected on follow-up magntic resonance imaging (MRI). The MRI of the PIF patients was registered to the planning CT and the PIF contoured. On the contralateral side of the fracture, a mirrored structure of the fracture was generated (mPIF). For the whole sacral bone, three lumbar vertebrae, the first and second sacral vertebrae, and the PIF, we analyzed the BMD (mg/cm3), V50Gy, Dmean, and Dmax.

Results

Out of 62 patients, 6 (9.7%) had a fracture. Two out of the 6 patients had a bilateral fracture with only one of them being symptomatic. PIF patients showed a significantly lower BMD in the sacral and the lumbar vertebrae (p < 0.05). The BMD of the contoured PIF, however, when comparing to the mPIF, did not reach significance (p < 0.49). The difference of the V50Gy of the sacrum in the PIF group compared to the other (OTH) patients, i.e. those without PIF, did not reach significance.

Conclusion

The dose does not seem to have a relevant impact on the incidence of PIF in our patients. One of the predisposing factors for developing PIF after radiotherapy seems to be the low BMD. We presented an easy method to assess the BMD in planning CTs.
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Metadata
Title
An easy way to determine bone mineral density and predict pelvic insufficiency fractures in patients treated with radiotherapy for cervical cancer
Authors
Drilon Kurrumeli
Markus Oechsner
Bianca Weidenbächer
Christine Brambs
Maximilian Löffler
Stephanie Elisabeth Combs
Kai Borm
Marciana Nona Duma
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 6/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-020-01690-0

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