Stress fractures: rare complication? Own observations with modern methods of diagnostics and radiation therapy
Abstract
Objective. There are some descriptions of different boness stress fractures in existing literature, among them fractures of os sacrum and femoral heads. We estimated radiotherapy dose on bones mentioned above and collated them with the revealed stress fractures in selected patients. Materials and methods. Since 2011 till 2015 year 129 patients with morphologically proven squamous cell anal cancer were treated with chemoradiotherapy IMRT and mytomycin-based CT. Results. Stress fractures of a sacrum without any symptoms was diagnosed on MRI scan in 5 (3.9 %) patients, aged 54-75, with stages IIIA/IIIB within one year since treatment finished. In our patients no one of those with stress fracture hadn ’t radiotherapy dose more than 45 Gy on sacrum. For dose estimation on femoral heads they were contoured as separate structure in 10 patients: D2 % was 41.62 ± 0.84 Gy, V45 was 3.08 ± 1.75 cm3. Conclusion. Stress fractures are rare but important complication of modern radiation therapy and call for modern diagnostic methods. State-of-art treatment involves radiotherapy and chemotherapy, and higher doses of radiotherapy on distinct regions of pelvic bones may increase the risk of stress fracture.
About the Authors
V. V. Glebovskaya
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
S. I. Tkachyov
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
A. V. Nazarenko
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
O. P. Trofimova
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
P. V. Bulychkin
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
E. V. Timoshkina
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
D. S. Romanov
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
O. S. Zaychenko
National Medical Research Centre of Oncology n.a. N. N. Blokhin
Russian Federation
Russian Federation
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Review
For citations:
Glebovskaya V.V., Tkachyov S.I., Nazarenko A.V., Trofimova O.P., Bulychkin P.V., Timoshkina E.V., Romanov D.S., Zaychenko O.S. Stress fractures: rare complication? Own observations with modern methods of diagnostics and radiation therapy. Medical alphabet. 2018;1(15):32-36. (In Russ.)
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