title: Pelvic insufficiency fractures in women following radiation treatment: a case series.
abstract: Insufficiency fractures are stress fractures that occur from normal weight-bearing on weakened bone. Radiation treatment to malignancies in the prostate, rectum, anus, or cervix may increase the risk of insufficiency fractures in the pelvic region by damaging osteoblasts that are essential to bone formation. In elderly women with cancer, this risk is greater due to their susceptibility to developing osteoporosis. These fractures may be confused with pathological fractures resulting from bone metastases on imaging and should be identified for proper management. We report two cases in which two women developed painful insufficiency fractures in the pelvic region after receiving radiation treatment to the rectum. After consulting an orthopedic surgeon, one patient underwent a cementoplasty, while the other patient was encouraged to take bone strengthening medications.
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Chan
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Leigha
authors.initials: L
authors.lastname: Rowbottom
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: McDonald
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: David
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Hans
authors.initials: H
authors.lastname: Chung
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Albert
authors.initials: A
authors.lastname: Yee
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Turner
authors.affiliation: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, ON, Canada. edward.chow@sunnybrook.ca.
authors.forename: Edward
authors.initials: E
authors.lastname: Chow
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy*; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary*; D060826:Cementoplasty / Q000379:methods; D005260:Female; D005598:Fractures, Spontaneous / Q000628:therapy*; D015775:Fractures, Stress / Q000628:therapy*; D006801:Humans; D010384:Pelvic Bones / Q000293:injuries*; D011878:Radiotherapy / Q000009:adverse effects; D012004:Rectal Neoplasms / Q000532:radiotherapy*
keywords: Bone metastases; insufficiency fracture; radiotherapy