放疗后病理性骨折：文献系统综述

Pathological fracture after radiotherapy: systematic review of literature.

作者信息

Soares Cláudio Beling Gonçalves, Araújo Ivana Duval de, Pádua Bruno Jannotti, Vilela José Carlos Souza, Souza Rodrigo Henriques Reis, Teixeira Luiz Eduardo Moreira

机构信息

MD, Doctorate student on Surgery at the Faculty of Medicine, UFMG, Belo Horizonte, MG, Brasil.

Ph.D., Department of Surgery, UFMG, Belo Horizonte, MG, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2019 Jul 22;65(6):902-908. doi: 10.1590/1806-9282.65.6.902.

DOI:10.1590/1806-9282.65.6.902

PMID:31340323

Abstract

OBJECTIVE

To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment.

METHODS

Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation.

RESULTS

The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation.

CONCLUSION

There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.

摘要

目的

评估放射治疗后继发性骨折的流行病学数据及可用治疗方法。

方法

识别先前暴露于电离辐射的病理性骨骼骨折的相关出版物。

结果

照射后骨折的发生率在1.2%至25%之间，愈合率为33%至75%，肋骨、骨盆和股骨骨折更为常见。照射与骨折之间的时间间隔发生在放射治疗后的数年。危险因素包括年龄超过50岁、女性、广泛的骨膜剥离、环形照射、肿瘤大小以及大腿前部位置。病因仍不确定，但观察到细胞消失、骨转换和造血活性降低可能是愈合失败的原因。