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학술저널
저자정보
Rhee, Woo Joong (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System) Kim, Kyung Hwan (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System) Chang, Jee Suk (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System) Kim, Hyun Ju (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System) Choi, Seohee (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System) Koom, Woong Sub (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University Health System)
저널정보
대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제32권 제4호
발행연도
2014.1
수록면
221 - 230 (10page)

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Purpose: To evaluate the risk of vertebral compression fracture (VCF) after conventional radiotherapy (RT) for colorectal cancer (CRC) with spine metastasis and to identify risk factors for VCF in metastatic and non-metastatic irradiated spines. Materials and Methods: We retrospectively reviewed 68 spinal segments in 16 patients who received conventional RT between 2009 and 2012. Fracture was defined as a newly developed VCF or progression of an existing fracture. The target volume included all metastatic spinal segments and one additional non-metastatic vertebra adjacent to the tumor-involved spines. Results: The median follow-up was 7.8 months. Among all 68 spinal segments, there were six fracture events (8.8%) including three new VCFs and three fracture progressions. Observed VCF rates in vertebral segments with prior irradiation or pre-existing compression fracture were 30.0% and 75.0% respectively, compared with 5.2% and 4.7% for segments without prior irradiation or pre-existing compression fracture, respectively (both p < 0.05). The 1-year fracture-free probability was 87.8% (95% CI, 78.2-97.4). On multivariate analysis, prior irradiation (HR, 7.30; 95% CI, 1.31-40.86) and pre-existing compression fracture (HR, 18.45; 95% CI, 3.42-99.52) were independent risk factors for VCF. Conclusion: The incidence of VCF following conventional RT to the spine is not particularly high, regardless of metastatic tumor involvement. Spines that received irradiation and/or have pre-existing compression fracture before RT have an increased risk of VCF and require close observation.

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