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耻骨骨髓炎:盆腔放疗的潜在致病作用

Osteomyelitis Pubis: The Possible Pathogenic Role of Pelvic Irradiation.

作者信息

Iacuzzo Cristiana, Monticelli Jacopo

机构信息

Department of General Surgery, University Hospital of Trieste, "Ospedale di Cattinara", Strada di Fiume 447, 34149 Trieste, Italy.

Infectious Diseases Unit, University Hospital of Trieste, "Ospedale Maggiore", Piazza dell'Ospitale 2, 34125 Trieste, Italy.

出版信息

Case Rep Orthop. 2017;2017:5961917. doi: 10.1155/2017/5961917. Epub 2017 Dec 3.

DOI:10.1155/2017/5961917
PMID:29619264
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5733125/
Abstract

Radiation to the pelvis, mainly directed against either prostatic or gynecologic cancers, is burdened by a lot of complications. The genitourinary tract is most frequently involved, presenting with bladder irritation, incontinence, and fertility disorders. However, side effects of radiation can also affect the bone, usually causing an osteolytic process which deteriorates the bone structure and leads to fractures, avascular necrosis, and other pathological insults. Here, we describe a case of osteomyelitis of the pubic symphysis as late complication of pelvic radiotherapy performed against prostate cancer.

摘要

盆腔放疗主要针对前列腺癌或妇科癌症,常伴有许多并发症。泌尿生殖道最常受累,表现为膀胱刺激、尿失禁和生育障碍。然而,放疗的副作用也会影响骨骼,通常会引发溶骨过程,使骨骼结构恶化,导致骨折、缺血性坏死和其他病理损伤。在此,我们描述一例耻骨联合骨髓炎,这是前列腺癌盆腔放疗的晚期并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/393a0f7af09b/CRIOR2017-5961917.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/2deb5c26c83e/CRIOR2017-5961917.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/9daed7fe1e92/CRIOR2017-5961917.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/393a0f7af09b/CRIOR2017-5961917.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/2deb5c26c83e/CRIOR2017-5961917.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/9daed7fe1e92/CRIOR2017-5961917.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0ac/5733125/393a0f7af09b/CRIOR2017-5961917.003.jpg

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本文引用的文献

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Prostate Cancer Radiation Therapy: What Do Clinicians Have to Know?前列腺癌放射治疗:临床医生需要了解什么?
Biomed Res Int. 2016;2016:6829875. doi: 10.1155/2016/6829875. Epub 2016 Dec 28.
2
Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.《念珠菌病管理临床实践指南:美国传染病学会2016年更新版》
Clin Infect Dis. 2016 Feb 15;62(4):e1-50. doi: 10.1093/cid/civ933. Epub 2015 Dec 16.
3
Pubic symphysis osteomyelitis in the prostate cancer survivor: clinical presentation, evaluation, and management.
前列腺癌幸存者的耻骨联合骨髓炎:临床表现、评估与管理
Urology. 2015 Mar;85(3):684-90. doi: 10.1016/j.urology.2014.11.020.
4
Hypofractionated versus conventionally fractionated radiotherapy for patients with prostate cancer (HYPRO): acute toxicity results from a randomised non-inferiority phase 3 trial.对于前列腺癌患者的低分割与常规分割放疗(HYPRO):一项随机非劣效性 3 期试验的急性毒性结果。
Lancet Oncol. 2015 Mar;16(3):274-83. doi: 10.1016/S1470-2045(14)70482-6. Epub 2015 Feb 3.
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A dosimetric comparison of volumetric modulated arc therapy with step-and-shoot intensity modulated radiation therapy for prostate cancer.容积调强弧形放疗与静态调强放射治疗前列腺癌的剂量学比较
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Proton beam and prostate cancer: An evolving debate.质子束与前列腺癌:一场不断演变的争论。
Rep Pract Oncol Radiother. 2013 Jul 3;18(6):338-42. doi: 10.1016/j.rpor.2013.06.001.
7
Candida osteomyelitis: analysis of 207 pediatric and adult cases (1970-2011).念珠菌性骨髓炎:207 例儿科和成人病例分析(1970-2011 年)。
Clin Infect Dis. 2012 Nov 15;55(10):1338-51. doi: 10.1093/cid/cis660. Epub 2012 Aug 21.
8
Postoperative radiotherapy for prostate cancer: a comparison of four consensus guidelines and dosimetric evaluation of 3D-CRT versus tomotherapy IMRT.前列腺癌术后放疗:四项共识指南比较及 3D-CRT 与 Tomotherapy-IMRT 的剂量学评估。
Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):725-32. doi: 10.1016/j.ijrobp.2011.12.081. Epub 2012 Mar 22.
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Pelvic bone complications after radiation therapy of uterine cervical cancer: evaluation with MRI.子宫颈癌放射治疗后骨盆骨并发症:MRI评估
AJR Am J Roentgenol. 2008 Oct;191(4):987-94. doi: 10.2214/AJR.07.3634.
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Dose-response in radiotherapy for localized prostate cancer: results of the Dutch multicenter randomized phase III trial comparing 68 Gy of radiotherapy with 78 Gy.局限性前列腺癌放射治疗的剂量反应:荷兰多中心随机III期试验比较68 Gy与78 Gy放射治疗的结果
J Clin Oncol. 2006 May 1;24(13):1990-6. doi: 10.1200/JCO.2005.05.2530.