Computerized tomography-based radiotherapy improves heterotopic ossification outcomes.
OBJECTIVE
To report the impact of computerized tomography (CT) based radiotherapy (RT) on heterotopic ossification (HO) outcomes.


METHODS
This is a single institution, retrospective study of 532 patients who were treated for traumatic acetabular fractures (TAF). All patients underwent open-reduction internal-fixation (ORIF) of the TAF followed by RT for HO prophylaxis. Postoperative RT was delivered within 72h, in a single fraction of 7Gy. The patients were divided into 2 groups based on RT planning: CT (A) vs. clinical setup (B).


RESULTS
At a median follow up of 8years the incidence of HO was 21.6%. Multivariate regression analysis revealed that group (A) vs. (B) had HO incidence of 6.6% vs. 24.6% (p<0.001), respectively. Furthermore, HO Brooker grade ≥3 was observed in 2.2% vs. 10.8% (p=0.007) in group (A) vs. (B), respectively. Thus, the odds of developing HO and Brooker grades ≥3 were 4.7 and 4.5 times higher, respectively, in patients who underwent clinical setup.


CONCLUSIONS
Our data suggest that using CT based RT allowed more accurate delineation of the tissues and better clinical outcomes. Although CT-based RT is associated with additional cost the efficacy of CT-based RT reduces the risk of HO, thereby decreasing the need for additional surgical interventions.
Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA. Electronic address: Waleed246@gmail.com.
Waleed F
WF
Mourad
Satya
S
Packianathan
John K
JK
Ma
Claus Chunli
CC
Yang
Rania A
RA
Shourbaji
Rui
R
He
Zhen
Z
Zhang
Madhava Rao
MR
Kanakamedala
Majid A
MA
Khan
Paul
P
Mobit
Evangelia
E
Katsoulakis
Thomas
T
Nabhani
Richard
R
Jennelle
George V
GV
Russell
Srinivasan
S
Vijayakumar
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
Acetabular fracture; Computerized tomography; Heterotopic ossification; Radiation therapy