Keywords:
Genital / Reproductive system female, Oncology, CT-Quantitative, Radiation therapy / Oncology, Demineralisation-Bone, Toxicity
Authors:
C. Godber, C. Clark, T. Diamond, R. Rahbari
DOI:
10.26044/ranzcr2023/C-154
Conclusion
This data demonstrates that the majority of patients treated with external beam radiotherapy for underlying Gynaecological malignancy developed severe osteoporosis or progressive bone loss at either the left femoral neck or lumbar spine. A more pronounced decrease in BMD was noted in the lumbar spine compared to the femoral neck. The effect of treatment field size was deemed to be a significant factor in lumbar spine bone loss. Radiotherapy dose was found to be directly correlated to BMD loss at the L3 vertebrae, however this relationship was not replicated at the left femoral head.
Limitations of this study include the retrospective design, the significant variation in the time from completion of radiotherapy to follow up QCT and patient selection bias. Comparison to age matched controls with non-malignant gynaecological disorders would be beneficial to further quantify the contribution of radiotherapy on bone loss. Nevertheless, this study provides valuable insight into the treatment factors contributing to BMD changes following radiotherapy to the pelvis. More detailed studies with risk stratification and management of these patients are required.