Sargos P, Mamou N, Dejean C, Figueiredo B Henriques de, Huchet A, Italiano A, Kantor G
Département de Radiothérapie, Centre Régional de Lutte Contre le Cancer, Institut Bergonié, 229 cours de l'Argonne, 33076 Bordeaux cedex, France.
Cancer Radiother. 2010 Jul;14(4-5):386-91. doi: 10.1016/j.canrad.2010.02.010. Epub 2010 Jun 1.
Radiation tolerance for bone tissue has been mostly evaluated with regard to bone fracture. Main circumstances are mandibula osteoradionecrosis, hip and costal fracture, and patent or radiologic fractures in the treated volume. After radiation therapy of bone metastasis, the analysis of related radiation fracture is difficult to individualize from a pathologic fracture. Frequency of clinical fracture is less than 5% in the large series or cohorts and is probably underevaluated for the asymptomatic lesions. Women older than 50 years and with osteoporosis are probably the main population at risk. Dose-effect relations are difficult to qualify in older series. Recent models evaluating radiations toxicity on diaphysa suggest an important risk after 60 Gy, for high dose-fraction and for a large volume.
骨组织的辐射耐受性大多是针对骨折进行评估的。主要情况包括下颌骨放射性骨坏死、髋部和肋骨骨折，以及治疗部位的显性或放射性骨折。骨转移瘤放疗后，相关放射性骨折的分析很难与病理性骨折区分开来。在大型系列研究或队列中，临床骨折的发生率低于5%，对于无症状病变可能评估不足。年龄超过50岁且患有骨质疏松症的女性可能是主要的风险人群。在早期研究中，剂量效应关系难以确定。最近评估骨干辐射毒性的模型表明，在60 Gy后、高剂量分割和大体积照射时存在重要风险。
