High Fracture Risk of Femoral Bone Metastasis Treated with Palliative Radiotherapy
Author Information
Author(s): Makita Kenji, Hojo Hidehiro, Oyoshi Hidekazu, Fujisawa Takeshi, Nakamura Masaki, Uchida Gyo, Koike Yume, Zhou Yuzheng, Tomizawa Kento, Fukushi Keiko, Zenda Sadamoto
Primary Institution: National Cancer Center Hospital East
Hypothesis
The study aimed to clarify the incidence of pathological fractures caused by high-risk femoral bone metastases after palliative radiotherapy in the era of bone-modifying agents.
Conclusion
The incidence of pathological fractures remained high in patients with high-risk femoral bone metastases treated with palliative radiotherapy, particularly those with axial cortical involvement ≥30 mm.
Supporting Evidence
- The incidence of pathological fractures was 22.8% and 31.0% at 2 and 6 months, respectively.
- Pathological fractures were caused by 17 of 65 lesions (26.2%) in patients who received BMAs.
- Pathological fractures were caused by 17 of 42 lesions (40.5%) with axial cortical involvement ≥30 mm.
Takeaway
This study found that many patients with certain types of bone cancer still break bones even after treatment, so doctors might need to do more surgery to help prevent this.
Methodology
The study assessed 90 patients with high-risk femoral bone metastases using Mirels’ scoring system and analyzed fracture incidence with the Kaplan–Meier method.
Potential Biases
Potential selection bias regarding the administration of bone-modifying agents and surgical stabilizations.
Limitations
The study's retrospective nature, small sample size, and inclusion of heterogeneous primary tumors may limit the findings.
Participant Demographics
{"age_range":"33–82","median_age":64,"sex_distribution":{"female":41,"male":49},"primary_tumors":{"lung":42,"breast":13,"esophagus":10,"renal":5,"pancreatic":4,"liver":3,"large_intestine":3,"prostate":2,"uterus":2,"stomach":2,"other":4}}
Statistical Information
P-Value
0.02
Statistical Significance
p = 0.02
Digital Object Identifier (DOI)
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