Pathological fracture after radiotherapy: systematic review of literature

• Main Author: Cláudio Beling Gonçalvessoares
• Publication Date: 2019
• Other Authors: Ivana Duval de Araújo, Bruno Jannotti Pádua, José Carlos Souza Vilela, Rodrigo Henriques Reis Souza, Luiz Eduardo Moreira Teixeira
• Format: Article
• Language: por
• Source: Repositório Institucional da UFMG
• Download full: https://doi.org/10.1590/1806-9282.65.6.902; http://hdl.handle.net/1843/53761
• topic: Fractures, Spontaneous; Fracture Healing; Radiotherapy; Radiation Effects; Fraturas Espontâneas; Consolidação da Fratura; Radioterapia; Efeitos da Radiação

OBJECTIVE: To evaluate the epidemiological data and available treatments for fractures secondary to radiotherapy treatment. METHODS: Identification of publications on pathological skeletal fractures previously exposed to ionizing radiation. RESULTS: The incidence of fractures after irradiation varies from 1.2% to 25% with a consolidation rate of 33% to 75%, being more frequent in the ribs, pelvis, and femur. The time elapsed between irradiation and fracture occurs years after radiotherapy. Risk factors include age above 50 years, female gender, extensive periosteal detachment, circumferential irradiation, tumor size, and anterior thigh location. The etiology is still uncertain, but cellular disappearance, reduction of bone turnover and activity were observed hematopoietic as possible causes of failure of consolidation.CONCLUSION: There is no consensus in the literature on the factors related to the development of fractures, with radiation dose, previous tumor size and periosteal detachment being suggested as potential factors.