宫颈癌放化疗所致功能不全性骨折研究进展北大核心CSCD

骨盆功能不全性骨折(PIF)是宫颈癌放化疗后未被充分认识、易被误诊为骨转移瘤的晚期并发症。既往临床上多着重于研究本病的发病率、时间、部位,对于发病潜在危险因素的分析多集中于患者临床特征,而对于治疗因素与发病的相关性研究较少。放疗后骨盆尤其是骶骨的损伤主要与照射方式、照射剂量有关。现对放疗技术、保骨放疗计划的制订、外照射及腔内近距离治疗的剂量体积参数、化疗与本病的相关性研究进行综述。未来能否根据精准放疗技术优势,优化保骨计划,降低骨盆受照范围及剂量,进而降低PIF发病率尚需进一步临床试验和实践来验证。

Research progress on pelvic insufficiency fracture (PIF) caused by radiotherapy and chemotherapy of cervical cancer

Pelvic insufficiency fracture (PIF) is a late complication which is not fully understood after radiotherapy and chemotherapy for cervical cancer and is easily misdiagnosed as bone metastasis. Previous clinical trials focused on the incidence, time and location of PIF, while the analysis of potential risk factors mainly emphasized the clinical characteristics of patients. There were few studies analyzing the correlation between treatment factors and the incidence. The damage of pelvis bone, especially the sacrum, after radiotherapy is mainly related to irradiation mode and dose. In this article, the radiotherapy technology, the formulation of bone‐conserving radiotherapy plan, the dose‐volume parameters of external irradiation and intracavitary brachytherapy, and the correlation between chemotherapy and this disease were reviewed. In the future, according to the advantages of precision radiotherapy technology, it is necessary to optimize the bone preservation plan, reduce the irradiation range and dose of sacrum and pelvis, and then reduce the incidence of PIF, which needs further clinical trials and practice to verify.