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Does intensity-modulated radiotherapy reduce the risk of pelvic insufficiency fractures in gynaecological cancers?

Published online by Cambridge University Press:  14 January 2015

Vivek Nama ,
John Hughes ,
Alison Stapleton  and
Hoda Al-Booz
Vivek Nama
Affiliation:
Department of Gyn Oncology, University of Bristol, Bristol, UK
John Hughes
Affiliation:
Department of Gyn Oncology, University of Bristol, Bristol, UK
Alison Stapleton
Affiliation:
Department of Gyn Oncology, University of Bristol, Bristol, UK
Hoda Al-Booz*
Affiliation:
Department of Gyn Oncology, University of Bristol, Bristol, UK
*
Correspondence to: Dr Hoda Al-Booz, Consultant Clinical Oncologist, Bristol Haematology and Oncology Centre, BS2 8ED Bristol, UK. Tel: 01173423008. Fax: 01173423572. E-mail: hoda.booz@UHBristol.nhs.uk
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Abstract

Background

Increasingly we are using a combination of surgery, chemotherapy and radiotherapy for treatment of gynaecological malignancies. Most studies in literature are concentrated on the concept of survival. There is minimal data examining the impact of these treatments on quality of life. Survival being a surrogate marker is an arbitrary end point and is of arguable significance if quality of life is not maintained. Long-term side effects of radiotherapy are debilitating and severely affect quality of life. Pelvic insufficiency fractures (PIF) are a known long-term side effect of radiotherapy. Intensity-modulated radiotherapy (IMRT) is being routinely used in the treatment of prostate and head and neck cancer. We postulated that use of IMRT in gynaecological cancers reduces the incidence of PIF.

Patients and methods

We retrospectively reviewed 10 cases of PIF treated on standard treatment. We recalculated dose volume histograms based on IMRT protocols for patients with PIF.

Results

We found that none of the patients received any radiation at the fracture site and the total radiation received to the sacrum was lower compared with the standard treatment protocols.

Conclusions

We conclude that the feasibility of IMRT in gynaecological cancers should be further evaluated and might be an useful tool in reducing the number of PIF.

Keywords

gynaecologyintensity-modulated radiotherapypelvic insufficiency fracturespelvic radiotherapy
Type
Short Communication
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 2 , June 2015 , pp. 219 - 222
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Copyright
© Cambridge University Press 2015 

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