Dataset Information

Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer.

ABSTRACT:

Purpose

Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones.

Materials and methods

For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared between patients with and without fractures.

Results

Posttreatment fractures occurred in 25 bones among ten patients. Pretreatment CT bone densities were significantly lower in patients with fractures (P?ConclusionPretreatment CT densities of spinal and pelvic bones, which may reflect osteoporosis, have a significant impact on the risk for posttreatment fractures.

SUBMITTER: Ishikawa K

PROVIDER: S-EPMC7813741 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer.

Ishikawa Kazuki K Yamashiro Tsuneo T Ariga Takuro T Toita Takafumi T Kudaka Wataru W Heianna Joichi J Maemoto Hitoshi H Kusada Takeaki T Makino Wataru W Aoki Yoichi Y Murayama Sadayuki S

Japanese journal of radiology 20200907 1

<h4>Purpose</h4>Fractures are known to shorten life expectancy and worsen the quality of life. The risk of fractures after radiation therapy in cervical cancer patients is known to be multifactorial. In this study, we examined risk factors for fractures in cervical cancer patients, especially by evaluating bone densities and DVH parameters for fractured bones.<h4>Materials and methods</h4>For 42 patients, clinical characteristics, pretreatment CT bone densities, and radiation dose were compared ...[more]

PMID: 32894410

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Project description:BackgroundUnplanned hospitalization during cancer treatment is costly, can disrupt treatment, and affect patient quality of life. However, incidence and risks factors for hospitalization during lung cancer radiotherapy are not well characterized.MethodsPatients treated with definitive intent radiation (?45?Gy) for lung cancer between 2008 and 2018 at a tertiary academic institution were identified. In addition to patient, tumor, and treatment related characteristics, specific baseline frailty markers (Charlson comorbidity index, ECOG, patient reported weight loss, BMI, hemoglobin, creatinine, albumin) were recorded. All cancer-related hospitalizations during or within 30?days of completing radiation were identified. Associations between baseline variables and any hospitalization, number of hospitalizations, and overall survival were identified using multivariable linear regression and multivariable Cox proportional-hazards models, respectively.ResultsOf 270 patients included: median age was 66.6?years (31-88), 50.4% of patients were male (n?=?136), 62% were Caucasian (n?=?168). Cancer-related hospitalization incidence was 17% (n?=?47), of which 21% of patients hospitalized (n?=?10/47) had >?1 hospitalization. On multivariable analysis, each 1?g/dL baseline drop in albumin was associated with a 2.4 times higher risk of any hospitalization (95% confidence interval (CI) 1.2-5.0, P?=?0.01), and baseline hemoglobin ?10 was associated with, on average, 2.7 more hospitalizations than having pre-treatment hemoglobin >?10 (95% CI 1.3-5.4, P?=?0.01). After controlling for baseline variables, cancer-related hospitalization was associated with 1.8 times increased risk of all-cause death (95% CI: 1.02-3.1, P?=?0.04).ConclusionsOur data show baseline factors can predict those who may be at increased risk for hospitalization, which was independently associated with increased mortality. Taken together, these data support the need for developing further studies aimed at early and aggressive interventions to decrease hospitalizations during treatment.

Project description:BACKGROUND:Some studies have demonstrated that concurrent chemo-radiotherapy is an effective salvage treatment for isolated para-aortic lymph node (PALN) recurrence. However, no studies have compared multi-treatment modalities, such as radiation therapy (RT), concurrent chemoradiotherapy (CCRT), surgery, chemotherapy, and best supportive care (BSC), across a sufficient number of patients with PALN recurrence. We thus aimed to evaluate the clinical outcomes of multi-treatment modalities for isolated PALN recurrence in uterine cervical cancer. METHODS:Records of 50 patients who were first diagnosed with isolated PALN recurrence after definitive cervical cancer treatment from 2002 to 2016 at our institution were reviewed retrospectively. The initial definitive cervical cancer therapies included RT alone, CCRT, or surgery with or without post-operative RT. The median follow-up time was 33?months. The median age at recurrence diagnosis was 57?years (range, 26-84?years). The median duration between the end of initial treatment and recurrence was 10?months (range, 1-91?months). The median maximum metastatic lesion size was 17?mm (range, 8-60?mm). Twenty-four patients had one or two PALN metastases, while 26 had 3 or more. Eighteen patients were treated for recurrence with RT alone, seven with CCRT, three with surgery, 17 with chemotherapy, and five with BSC. Potential prognostic factors included histopathology, initial FIGO stage, initial treatment, age at recurrence, tumor markers (serum SCC-Ag and CEA) at recurrence, time to recurrence, maximum size of the metastatic lesion, number of metastases, and the recurrence treatment method. RESULTS:The 3-year overall survival (OS) rates of all patients were 47.0%. The 3-year OS rate of patients who underwent CCRT for recurrence was 85.7%; surgery, 66.7%; chemotherapy, 48.8%; RT, 41.3%; and BSC, 0% (p?=?0.014). Univariate analysis revealed that only the recurrence treatment method was significantly associated with OS. The 3-year local control rate (LCR) and progression free survival (PFS) rate for CCRT were 100 and 71.4%; for surgery, 100 and 66.7%; for chemotherapy, 33.6 and 13.7%; and for RT, 55.5 and 14.1%, respectively (LCR: p?=?0.028, PFS: p?=?0.059). The number of metastatic lesions, SCC-Ag levels and recurrence treatment method were significantly associated with LCR. Age at recurrence, SCC-Ag levels, and number of metastatic lesions were significantly associated with PFS. CONCLUSIONS:Although our patient cohort size was small, our results suggest that CCRT may be effective in preventing local disease recurrence in the PALN and may improve OS.

Dataset Information

Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer.

Purpose

Materials and methods

Results

Publications

Predictive factors of posttreatment fracture by definitive radiotherapy for uterine cervical cancer.

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