Radiotherapy as a local treatment option for heterotopic ossifications in patients with spinal cord injury.
OBJECTIVE
Heterotopic ossifications (HO) occur in about 20% of patients with spinal cord injury and may seriously compromise the rehabilitation process. The aim of the present study was to ascertain whether radiotherapy (RT) administered early in the course of the disease prevents the manifestation of HO and whether in patients, whose HO have been resected, recurrence can be avoided.


METHODS
Thirty-six patients (46 joints) were irradiated; 33 patients were evaluable. Mean follow up was 23.6 months. In 27 patients RT was performed as primary treatment in the inflammatory phase of soft tissue swelling that precedes manifest HO. Eleven patients were treated after resection of manifest HO, while two had primary and postoperative RT in different joints. The dose was 10 Gy in fractions of 2-2.5 Gy in 25 patients. Four patients were treated with total doses between 7.5 and 20 Gy. Seven patients received single dose irradiation with 8 Gy. RT was performed with 8 MV photons after simulation on the basis of CT scans.


RESULTS
The mean duration of follow up was 23.6 months. Thirty of the 36 irradiated patients showed no progression of HO. In three patients reossifications after therapy caused a moderate decrease in joint mobility. No relevant adverse effects were observed.


CONCLUSIONS
These results suggest that RT is a safe and effective local treatment option for spinal cord injury patients with HO.
Sautter-Bihl
M L
ML
Department of Radiooncology, Klinik fur Strahlentherapie, Städtisches Klinikum Karlsruhe, Germany.
Liebermeister
E
E
Nanassy
A
A
D000293:Adolescent; D000328:Adult; D002114:Calcinosis / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013119:Spinal Cord Injuries / Q000150:complications / Q000532:radiotherapy*; D016896:Treatment Outcome