Insufficiency fractures following pelvic radiotherapy of gynecologic malignancies

OBJECTIVES: In this article, insufficiency fractures (IF) after pelvic radiotherapy were examined. METHODS: We studied nine gynecologic malignancy patients who underwent pelvic radiotherapy. Patients’ ages, menopausal status, external pelvic radiotherapy dose, IF localization area and development time, treatment, and treatment response time were investigated. RESULTS: The mean age was 54 years. Five patients were postmenopausal, and five patients had osteoporosis. The mean follow-up and development period of IF were 49 and 26.8 months, respectively. The IF field was located in the sacrum in 8 patients and the sacroiliac joint in 1 patient. Pelvic pain was the initial complaint in 8 patients. One patient was asymptomatic. IF formation time ranged from 6-156 months. After symptomatic medical therapy and resting, the visual analogue scale (VAS) score decreased from 7 initially to 2. Treatment response time was 3.4 months. CONCLUSION: IF should be considered as a late complication of external radiotherapy in patients experiencing pelvic pain after pelvic radiotherapy.