Pathologic fractures as a late complication of postoperative radiotherapy of soft tissue sarcomas of the lower extremities
Abstract
Background: The mainstay of treatment of soft tissue sarcomas is surgery, in indicated cases followed by postoperative radiotherapy. Pathological fracture resulting from late toxicity of radiotherapy, especially in the lower extremities, significantly affects the patient's quality of life. The aim of this report is to analyze the frequency of pathological fractures in patients treated with adjuvant radiotherapy.
Patients and methods: During the period 2007-2018 forty one patients were treated with adjuvant radiotherapy at the Institute of Radiation Oncology of Bulovka University Hospital (IRO BUH). All patients underwent 3D conformal radiotherapy.
Results: Median Progression Free Survival (PFS) was 56 months and median Overall Survival (OS) was 94 months. Post-radiation pathologic fracture occurred in 4 patients (9.8%), with 1 case of subsequent refracture (2.4%). The median time to pathological fracture from the end of radiotherapy in our cohort was 26 months (15-35 months).
Conclusion: In our group, the occurrence of post-radiation fractures corresponding to the data available in the literature was proved. Given the significant negative impact of fractures on the quality of life of patients, it is necessary to continue to search for ways to prevent their occurrence.