What question did this study set out to answer?

This study aims to reassess the incidence and factors associated with pelvic insufficiency fractures after pelvic radiation therapy in female patients.

March 26, 2026Open Access

Pelvic insufficiency fractures after radiation therapy for pelvic cancer in female patients: an updated meta-analysis of 11,272 patients

Puntos clave

This study aims to reassess the incidence and factors associated with pelvic insufficiency fractures after pelvic radiation therapy in female patients.
Performed a systematic search across PubMed, Web of Science, and Cochrane Library for relevant cohort studies.
Analyzed data on pelvic insufficiency fracture incidence, location, and radiation therapy methods.
Used random-effects models and conducted subgroup analyses to address heterogeneity.
Pooled incidence of pelvic insufficiency fractures is 17%, an increase from the previous 14%.
Sacral bone/sacroiliac joint involvement is most prevalent at 71%, followed by pubic bone at 11.6%.
Definitive radiation therapy shows higher PIF rates (25%) compared to adjuvant therapy (6%).
Modern techniques like IMRT show reduced PIF rates compared to older methods.
MRI detects more PIFs (19%) than other imaging modalities (14%).

Resumen

Pelvic insufficiency fractures (PIFs) are a debilitating complication of pelvic radiotherapy (RT) for pelvic cancer in female patients, which could lead to a sharp decline in patients’ quality of life. A 2019 meta-analysis by Lucas Gomes Sapienza reported a PIF rate of 14%, but advancements in RT techniques (IMRT, VMAT, C-ion RT) and new published studies necessitate an updated analysis. This study aimed to re-evaluate PIF incidence, fracture location, and associated factors using recent high-quality evidence. A systematic search of PubMed, Web of Science and Cochrane Library (1980–April 2025) with cohort studies for gynecologic/anal/rectal cancers, pelvic insufficiency fractures. Data on PIF incidence, location, and RT methods were extracted. Random-effects models were used to address expected high heterogeneity. Subgroup analyses were explored in detail. The pooled PIF incidence was 17% (95% CI: 15–20%), higher than the prior 14% estimate. Sacral bone/sacroiliac joint involvement dominated (71%), followed by pubic bone (11.6%). Subgroup analyses revealed higher PIF rates with definitive RT (25%) vs. adjuvant RT (6%). Modern RT techniques (IMRT: 8%, 3D-CRT: 11%) reduced PIF risk vs. historical methods (AP/PA: 22%, 4-field: 18%). However, VMAT and C-ion RT showed elevated rates (30%), likely due to higher doses (≥ 55 Gy). Regional difference indicates Europe (23%) > Asia (20%) > USA (9%). MRI detected more PIFs (19%) than other modalities (14%). Low BMI (16%) and menopause (18%) correlated with higher PIF risk. The incidence of PIF after pelvic RT has risen in recent years. Sacral regions are highly likely to develop PIF. Modern RT techniques like IMRT are required, along with routine MRI surveillance.

Preguntar a la IA

Me gusta

Guardar

Ver artículo completo

Cite This Study

Gao et al. (Tue,) studied this question.

synapsesocial.com/papers/69c4ccebfdc3bde448918956 https://doi.org/https://doi.org/10.1007/s00402-026-06269-5

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Preguntar a la IA

Me gusta

Guardar

Ver artículo completo