Pelvic insufficiency fractures after whole pelvic irradiation for uterine cervical cancer

Pelvic insufficiency fractures (PIFs) are not a rare complication among patients with uterine cervical cancer treated by radiotherapy. The authors evaluated the rates of and risk factors for PIF after radiotherapy for cervical cancer at their institution. They enrolled 97 patients in this retrospective study. The median prescribed dose to the whole pelvis was 45 (range, 39.6-50.4) Gy. The median follow-up period was 26 months. PIF was detected at 23 sites in 15 patients (15.5%). A total of six of the 15 PIF patients (40.0%) had pain due to PIF. The cumulative PIF rates at one, two, and three years after radiotherapy were 9.0%, 16.3%, and 18.7%, respectively. Prescribed dose was the only risk factor associated with PIF in multivariate analysis. In most PIF patients, with pain is mild and can be controlled with nonsteroidal anti-inflammatory drugs. Physicians should have sufficient knowledge about PIF in order to conduct an accurate medical interview.

Uterine cervical cancer; Radiotherapy; Insufficiency fractures; Adverse event.

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