Pelvic Radiotherapy Ups Fracture Risk

The results of a new study indicate thatolder women who undergo radiation to treatcervical, anal, or rectal cancer have anincreased risk of pelvic fracture. Researcherssuggest that "these women could be targetedfor preventive strategies," such as bone mineraldensity screening, drug therapy to preventosteoporosis, and fall prevention. Thefindings were published in the Journal of theAmerican Medical Association (November23/30, 2005).

Researchers at the University of Minnesotain Minneapolis linked data from theSurveillance, Epidemiology, and End Resultscancer registry to Medicare claims data. Thestudy included 6428 women aged 65 yearsand older who were treated for pelvic malignanciesbetween 1986 and 1999. Of thesewomen, 2855 underwent radiation therapyas part of their treatment. Within the first 5years of the study, those who received radiationtherapy for anal cancer had the highestrate of pelvic fractures—14%—comparedwith 7.5% who did not receive radiation.Similar patterns were observed in patientswith cervical cancer (8.2% vs 5.9%) and rectalcancer (11.2% vs 8.7%).

The investigators attribute the higher risk inthe anal cancer group to the need to treatcancerous lymph nodes in the groin area,which are hard to treat without also exposingthe thighbone to radiation. They hope that bettertargeting of radiation therapy could somedayreduce the volume of healthy tissueexposed to radiation, thus decreasing suchadverse side effects.