%0 Journal Article
%T Pelvic Insufficiency Fractures after Chemoradiation for Gynecologic Malignancies: A Review of Seven Cases
%A Emeline M. Aviki
%A Sophie M. Cowan
%A Laura Young
%A Marcela G. Del Carmen
%A Whitfield B. Growdon
%A Anthony H. Russell
%A Annekathryn Goodman
%J International Journal of Clinical Medicine
%P 32-43
%@ 2158-2882
%D 2013
%I Scientific Research Publishing
%R 10.4236/ijcm.2013.412A1007
%X <p>
	<span style=\"font-family:Verdana;\">Background: </span><span style=\"font-family:Verdana;\">Radiation-induced
pelvic insufficiency fracture (PIF) is an important complication associated
with pelvic radiation therapy (RT) for patients with gynecologic malignancies.
Despite known risk factors and recent reports describing</span><span style=\"font-family:Verdana;\"> the</span><span><span style=\"font-family:Verdana;\"> incidence on the order of 30 percent,
there has been a dearth of translational research or consensus statements to
guide clinical management. </span><span style=\"font-family:Verdana;\">Objective:</span><span style=\"font-family:Verdana;\"> The aim of this study is to describe seven cases of PIF diagnosed and managed
at the Massachusetts General Hospital during a 5-year period and to perform a
focused review of the literature to inform several clinical questions that
remain unanswered. A secondary aim of this study is to highlight the need for
additional research related to screening, prophylaxis, diagnostics, and
treatment of PIF in patients with gynecologic malignancy. </span><span style=\"font-family:Verdana;\">Methods:</span><span style=\"font-family:Verdana;\"> In the current retrospective review, we report 10 cases of
PIF diagnosed over a 5-year period in 7 patients with vulva</span></span><span style=\"font-family:Verdana;\">r </span><span style=\"font-family:Verdana;\">(4), vaginal</span><span> </span><span style=\"font-family:Verdana;\">(2), and cervical</span><span> </span><span style=\"font-family:Verdana;\">(1) cancer following chemoradiation
therapy at a single institution. Data w</span><span style=\"font-family:Verdana;\">ere</span><span><span style=\"font-family:Verdana;\"> collected from the medical records by
a single investigator and all diagnostic imaging was reviewed by a single
radiologist to confirm the presence or absence of PIF. </span><span style=\"font-family:Verdana;\">Results: </span><span style=\"font-family:Verdana;\">All 7 patients were post-menopausal and received
concurrent chemoradiation, 3 were over the age of 65 years old (42.8%), 3 had
BMI &lt; 25</span></span><span> </span><span><span style=\"font-family:Verdana;\">kg/m</span><sup><span style=\"font-family:Verdana;\">2</span></sup><span style=\"font-family:Verdana;\"> (42.8%), 2 had a history of osteoporosis (28.6%), and 1 had a history of
hormone replacement therapy use (14.3%). No patients underwent standard
screening for PIF and no patients were started on prophylaxis prior to
diagnosis. </span></span><span style=\"font-family:Verdana;\">The
%K Pelvic Insufficiency Fracture
%K Vulva Cancer
%K Cervical Cancer
%K Radiation
%K Chemotherapy
%K Diagnostic Imaging
%K Fracture Screening
%K Fracture Prophylaxis
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=41416