Fractures of thoracic vertebrae in patients with locally advanced non-small cell lung carcinoma treated with intensity modulated radiotherapy

Radiother Oncol. 2016 Mar;118(3):437-41. doi: 10.1016/j.radonc.2015.11.011. Epub 2016 Jan 16.

Abstract

Purpose: To report on the incidence of vertebral fractures in patients treated with Intensity Modulated Radiotherapy (IMRT) for locally advanced non-small cell lung carcinoma (NSCLC) and to analyse the association with clinical and dosimetric parameters.

Patients and methods: Between 2007 and 2012, 524 patients treated with ⩾51 Gy were retrospectively analysed for the incidence of vertebral fractures (VF). Clinical parameters were assessed. In addition, a case control study in 50 patients was performed to study the association between the radiotherapy dose and fractured vertebrae.

Results: Three hundred and thirty-six patients were eligible for analyses. Twenty-eight patients (8%) were observed with VF at a median follow up of 12 months. Age was significantly higher in the group with VF (p<0.01). After balancing age, the mean vertebrae dose was most significantly associated with fractures of the vertebrae (p<0.01).

Conclusion: VF was observed in 8% of the patients with locally advanced NSCLC. RT dose was associated with the occurrence of thoracic vertebral fractures.

Keywords: IMRT; NSCLC; Toxicity; Vertebrae.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Case-Control Studies
  • Female
  • Fractures, Spontaneous / etiology
  • Humans
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Retrospective Studies
  • Small Cell Lung Carcinoma / radiotherapy*
  • Spinal Fractures / etiology
  • Thoracic Vertebrae / injuries
  • Thoracic Vertebrae / radiation effects*