Baxter et al reported an elevated risk for pelvic or femoral neck fractures in women following pelvic irradiation for cancer. A woman at increased risk may benefit from prophylactic measures to reduce the risk. The authors are from the University of Minnesota and the University of North Carolina at Chapel Hill.
Patient selection: woman receiving pelvic irradiation for cancer >= 65 years of age
Tumors treated with radiation:
(1) anal carcinoma (highest risk for pelvic fracture)
(2) rectal carcinoma
(3) cervical carcinoma
Risk factors:
(1) osteoporosis
(2) falls
(3) high radiation dose to bone
Preventive strategies:
(1) monitoring and treatment of osteoporosis
(2) fall prevention
(3) use a radiation technique that minimizes the dose received by bone
In the implementation I tried to capture this using the following untested score:
|
Parameter |
Finding |
Points |
|
carcinoma type |
non-anal |
0 |
|
|
anal carcinoma |
1 |
|
osteoporosis |
none |
0 |
|
|
mild |
0 |
|
|
moderate |
1 |
|
|
severe |
2 |
|
trauma |
none |
0 |
|
|
minor |
1 |
|
|
significant |
2 |
|
bone irradiation dose |
minimal |
0 |
|
|
moderate |
1 |
|
|
high |
2 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk for pelvic or femoral neck fracture.
Purpose: To evaluate the risk for pelvic or femoral neck fracture in a woman treated with pelvic irradiation.
Specialty: Hematology Oncology, Surgery, orthopedic
Objective: risk factors, adverse effects
ICD-10: S72.0,
