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Investigation of differences of sacral and vertebral bone mineral densities before and after radiotherapy in patients with locally advanced rectal cancer
Radiotherapy is a treatment method performed using ionizing radiation on cancer patients either alone or with surgery and/or chemotherapy. Although modern radiotherapy techniques provide a significant advantage in protecting healthy tissues, it is inevitable that normal tissues are also located in t...
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| Published in: | Cancer radiothérapie 2019-09, Vol.23 (5), p.408-415 |
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| creator | Hayar, M. Durankuş, N.K. Altun, G.D. Koçak, Z. Uzal, M.C. Saynak, M. |
| description | Radiotherapy is a treatment method performed using ionizing radiation on cancer patients either alone or with surgery and/or chemotherapy. Although modern radiotherapy techniques provide a significant advantage in protecting healthy tissues, it is inevitable that normal tissues are also located in the areas targeted by radiations. In this study, we aimed to examine the bone mineral density changes in bone structures commonly included in the irradiated area such as, L5 vertebra, sacrum, and femur heads, in patients who have received pelvic radiotherapy; and the relationship between these changes with radiation dose.
Patients included in the study had been previously diagnosed with rectal cancer, which were operated or not. Preoperative or postoperative pelvic radiotherapy was planned for all patients. In terms of convenience when comparing with future scans, all densitometry and CT scans were performed with the same devices. Fifteen patients were included in the study. In order to determine the dose of radiation each identified area had taken after radiotherapy, the sacrum, L5 vertebra, bilateral femoral heads, and L1 regions were contoured in the CT scans in which treatment planning was done. Sagittal cross-sectional images were taken advantage of while these regions were being contoured.
Bone mineral density was evaluated with CT and dual-energy X-ray absorptiometry before and after the treatment. The regions that have theoretically been exposed to irradiation, such as L5, sacrum, left to right femur were found to have significant difference in terms of bone density. According to CT evaluation, there was a significant decrease in bone intensity of L5, sacrum, left and right femurs. Dual-energy X-ray absorptiometry assessment revealed that the whole of the left femoral head, left femur neck and Ward's region were significantly affected by radiotherapy. However, there was no significant difference in the sacrum and L5 vertebra before and after radiotherapy.
More accurate results could be achieved if the same study was conducted on a larger patient population, with a longer follow-up period. When the reduction in bone density is at maximum or a cure is likely in a long-term period, bone mineral density could be determined by measurements performed at regular intervals.
La radiothérapie est une méthode de traitement réalisée à l’aide de rayonnements ionisants chez des patients atteints de cancer, soit utilisée seule, soit dans le cadre d’une prise en charge p |
| doi_str_mv | 10.1016/j.canrad.2019.05.014 |
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Patients included in the study had been previously diagnosed with rectal cancer, which were operated or not. Preoperative or postoperative pelvic radiotherapy was planned for all patients. In terms of convenience when comparing with future scans, all densitometry and CT scans were performed with the same devices. Fifteen patients were included in the study. In order to determine the dose of radiation each identified area had taken after radiotherapy, the sacrum, L5 vertebra, bilateral femoral heads, and L1 regions were contoured in the CT scans in which treatment planning was done. Sagittal cross-sectional images were taken advantage of while these regions were being contoured.
Bone mineral density was evaluated with CT and dual-energy X-ray absorptiometry before and after the treatment. The regions that have theoretically been exposed to irradiation, such as L5, sacrum, left to right femur were found to have significant difference in terms of bone density. According to CT evaluation, there was a significant decrease in bone intensity of L5, sacrum, left and right femurs. Dual-energy X-ray absorptiometry assessment revealed that the whole of the left femoral head, left femur neck and Ward's region were significantly affected by radiotherapy. However, there was no significant difference in the sacrum and L5 vertebra before and after radiotherapy.
More accurate results could be achieved if the same study was conducted on a larger patient population, with a longer follow-up period. When the reduction in bone density is at maximum or a cure is likely in a long-term period, bone mineral density could be determined by measurements performed at regular intervals.
La radiothérapie est une méthode de traitement réalisée à l’aide de rayonnements ionisants chez des patients atteints de cancer, soit utilisée seule, soit dans le cadre d’une prise en charge par chirurgie ou par chimiothérapie. Bien que les techniques modernes de radiothérapie soient un avantage important pour la protection des tissus sains, il est inévitable que les tissus normaux soient également situés dans les zones visées par la radiothérapie. Dans cette étude, nous avons examiné les modifications de la densité minérale dans les structures osseuses communément incluses dans le volume de la radiothérapie pelvienne, telles que la vertèbre L5, le sacrum et les têtes de fémur et la relation entre ces changements avec la dose de rayonnement.
Les patients inclus dans l’étude étaient atteints d’un cancer du rectum, opéré ou non. Une radiothérapie pelvienne préopératoire ou postopératoire a été planifiée pour tous les patients. Les analyses tomodensitométriques ont été réalisées avec les mêmes appareils. Quinze patients ont été inclus dans l’étude. Afin de déterminer la dose délivrée de rayonnement, les régions du sacrum, de la vertèbre L5, de la tête fémorale bilatérale et de la vertèbre L1 ont été délinéées. Des images en coupes sagittales ont été exploitées pour cela.
L’intensité minérale osseuse a été évaluée par tomodensitométrie et dual-energy X-ray absorptiometry avant et après le traitement. Les régions exposées à l’irradiation comme la vertèbre L5, le sacrum, les fémurs gauche et droit, ont montré une différence significative en termes de densité osseuse. Selon l’évaluation par tomodensitométrie, il y avait diminution significative de la densité de l’os jusqu’à la vertèbre L5, le sacrum, les fémurs gauche et droit. L’évaluation par dual-energy X-ray absorptiometry a révélé que l’ensemble de la tête fémorale gauche, du col du fémur gauche et de la région de Ward étaient significativement affectés par la radiothérapie. Cependant, pour le sacrum et la vertèbre L5, il n’y avait pas de différence significative avant et après la radiothérapie.
Des résultats plus précis pourraient être obtenus si la même étude était menée dans une population de patients plus importante, avec une période de suivi plus longue. Lorsque la réduction de la densité osseuse est maximale ou qu’il y a une probabilité de guérison à long terme, elle peut être déterminée par des mesures de densité effectuées à intervalles réguliers.</description><identifier>ISSN: 1278-3218</identifier><identifier>EISSN: 1769-6658</identifier><identifier>DOI: 10.1016/j.canrad.2019.05.014</identifier><identifier>PMID: 31331841</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Bone ; Cancer ; Density ; Densité ; Pelvic ; Pelvien ; Radiotherapy ; Radiothérapie ; Rectum</subject><ispartof>Cancer radiothérapie, 2019-09, Vol.23 (5), p.408-415</ispartof><rights>2019 Société française de radiothérapie oncologique (SFRO)</rights><rights>Copyright © 2019 Société française de radiothérapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-e44aba99426e71444f698958a7a39b11906cfecc9b33e33b70611d38f234fdbe3</citedby><cites>FETCH-LOGICAL-c362t-e44aba99426e71444f698958a7a39b11906cfecc9b33e33b70611d38f234fdbe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31331841$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hayar, M.</creatorcontrib><creatorcontrib>Durankuş, N.K.</creatorcontrib><creatorcontrib>Altun, G.D.</creatorcontrib><creatorcontrib>Koçak, Z.</creatorcontrib><creatorcontrib>Uzal, M.C.</creatorcontrib><creatorcontrib>Saynak, M.</creatorcontrib><title>Investigation of differences of sacral and vertebral bone mineral densities before and after radiotherapy in patients with locally advanced rectal cancer</title><title>Cancer radiothérapie</title><addtitle>Cancer Radiother</addtitle><description>Radiotherapy is a treatment method performed using ionizing radiation on cancer patients either alone or with surgery and/or chemotherapy. Although modern radiotherapy techniques provide a significant advantage in protecting healthy tissues, it is inevitable that normal tissues are also located in the areas targeted by radiations. In this study, we aimed to examine the bone mineral density changes in bone structures commonly included in the irradiated area such as, L5 vertebra, sacrum, and femur heads, in patients who have received pelvic radiotherapy; and the relationship between these changes with radiation dose.
Patients included in the study had been previously diagnosed with rectal cancer, which were operated or not. Preoperative or postoperative pelvic radiotherapy was planned for all patients. In terms of convenience when comparing with future scans, all densitometry and CT scans were performed with the same devices. Fifteen patients were included in the study. In order to determine the dose of radiation each identified area had taken after radiotherapy, the sacrum, L5 vertebra, bilateral femoral heads, and L1 regions were contoured in the CT scans in which treatment planning was done. Sagittal cross-sectional images were taken advantage of while these regions were being contoured.
Bone mineral density was evaluated with CT and dual-energy X-ray absorptiometry before and after the treatment. The regions that have theoretically been exposed to irradiation, such as L5, sacrum, left to right femur were found to have significant difference in terms of bone density. According to CT evaluation, there was a significant decrease in bone intensity of L5, sacrum, left and right femurs. Dual-energy X-ray absorptiometry assessment revealed that the whole of the left femoral head, left femur neck and Ward's region were significantly affected by radiotherapy. However, there was no significant difference in the sacrum and L5 vertebra before and after radiotherapy.
More accurate results could be achieved if the same study was conducted on a larger patient population, with a longer follow-up period. When the reduction in bone density is at maximum or a cure is likely in a long-term period, bone mineral density could be determined by measurements performed at regular intervals.
La radiothérapie est une méthode de traitement réalisée à l’aide de rayonnements ionisants chez des patients atteints de cancer, soit utilisée seule, soit dans le cadre d’une prise en charge par chirurgie ou par chimiothérapie. Bien que les techniques modernes de radiothérapie soient un avantage important pour la protection des tissus sains, il est inévitable que les tissus normaux soient également situés dans les zones visées par la radiothérapie. Dans cette étude, nous avons examiné les modifications de la densité minérale dans les structures osseuses communément incluses dans le volume de la radiothérapie pelvienne, telles que la vertèbre L5, le sacrum et les têtes de fémur et la relation entre ces changements avec la dose de rayonnement.
Les patients inclus dans l’étude étaient atteints d’un cancer du rectum, opéré ou non. Une radiothérapie pelvienne préopératoire ou postopératoire a été planifiée pour tous les patients. Les analyses tomodensitométriques ont été réalisées avec les mêmes appareils. Quinze patients ont été inclus dans l’étude. Afin de déterminer la dose délivrée de rayonnement, les régions du sacrum, de la vertèbre L5, de la tête fémorale bilatérale et de la vertèbre L1 ont été délinéées. Des images en coupes sagittales ont été exploitées pour cela.
L’intensité minérale osseuse a été évaluée par tomodensitométrie et dual-energy X-ray absorptiometry avant et après le traitement. Les régions exposées à l’irradiation comme la vertèbre L5, le sacrum, les fémurs gauche et droit, ont montré une différence significative en termes de densité osseuse. Selon l’évaluation par tomodensitométrie, il y avait diminution significative de la densité de l’os jusqu’à la vertèbre L5, le sacrum, les fémurs gauche et droit. L’évaluation par dual-energy X-ray absorptiometry a révélé que l’ensemble de la tête fémorale gauche, du col du fémur gauche et de la région de Ward étaient significativement affectés par la radiothérapie. Cependant, pour le sacrum et la vertèbre L5, il n’y avait pas de différence significative avant et après la radiothérapie.
Des résultats plus précis pourraient être obtenus si la même étude était menée dans une population de patients plus importante, avec une période de suivi plus longue. Lorsque la réduction de la densité osseuse est maximale ou qu’il y a une probabilité de guérison à long terme, elle peut être déterminée par des mesures de densité effectuées à intervalles réguliers.</description><subject>Bone</subject><subject>Cancer</subject><subject>Density</subject><subject>Densité</subject><subject>Pelvic</subject><subject>Pelvien</subject><subject>Radiotherapy</subject><subject>Radiothérapie</subject><subject>Rectum</subject><issn>1278-3218</issn><issn>1769-6658</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kc2OFCEUhYnROD_6BsawdFM1UFBUsTExk3Fmkknc6Jrwc3HoVEMLdJt-FN9Wyh5nOSs4yXfvgXMQ-kBJTwkVV5ve6pi16wdCZU_GnlD-Cp3TSchOiHF-3e7DNHdsoPMZuihlQwgRQo5v0RmjjNGZ03P05z4eoNTwU9eQIk4eu-A9ZIgWyiqLtlkvWEeHD5ArmFWZFAFvQ4RVOIgl1NBwAz5l-MdqXyHj9ryQ6mPDdkccIt41F4i14N-hPuIlWb0sR6zdQTc7hzPY2hbaVeV36I3XS4H3T-cl-vH15vv1Xffw7fb--stDZ5kYageca6Ol5IOAiXLOvZCzHGc9aSYNpZII68FaaRgDxsxEBKWOzX5g3DsD7BJ9Ou3d5fRr37JQ21AsLIuOkPZFDcPMKGmBiobyE2pzKiWDV7sctjofFSVqLUVt1KkUtZaiyKhaKW3s45PD3mzBPQ_9b6EBn08AtH8eAmRVbFgbcGGNRLkUXnb4C-M4osM</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Hayar, M.</creator><creator>Durankuş, N.K.</creator><creator>Altun, G.D.</creator><creator>Koçak, Z.</creator><creator>Uzal, M.C.</creator><creator>Saynak, M.</creator><general>Elsevier Masson SAS</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201909</creationdate><title>Investigation of differences of sacral and vertebral bone mineral densities before and after radiotherapy in patients with locally advanced rectal cancer</title><author>Hayar, M. ; Durankuş, N.K. ; Altun, G.D. ; Koçak, Z. ; Uzal, M.C. ; Saynak, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-e44aba99426e71444f698958a7a39b11906cfecc9b33e33b70611d38f234fdbe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Bone</topic><topic>Cancer</topic><topic>Density</topic><topic>Densité</topic><topic>Pelvic</topic><topic>Pelvien</topic><topic>Radiotherapy</topic><topic>Radiothérapie</topic><topic>Rectum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hayar, M.</creatorcontrib><creatorcontrib>Durankuş, N.K.</creatorcontrib><creatorcontrib>Altun, G.D.</creatorcontrib><creatorcontrib>Koçak, Z.</creatorcontrib><creatorcontrib>Uzal, M.C.</creatorcontrib><creatorcontrib>Saynak, M.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer radiothérapie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hayar, M.</au><au>Durankuş, N.K.</au><au>Altun, G.D.</au><au>Koçak, Z.</au><au>Uzal, M.C.</au><au>Saynak, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Investigation of differences of sacral and vertebral bone mineral densities before and after radiotherapy in patients with locally advanced rectal cancer</atitle><jtitle>Cancer radiothérapie</jtitle><addtitle>Cancer Radiother</addtitle><date>2019-09</date><risdate>2019</risdate><volume>23</volume><issue>5</issue><spage>408</spage><epage>415</epage><pages>408-415</pages><issn>1278-3218</issn><eissn>1769-6658</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Radiotherapy is a treatment method performed using ionizing radiation on cancer patients either alone or with surgery and/or chemotherapy. Although modern radiotherapy techniques provide a significant advantage in protecting healthy tissues, it is inevitable that normal tissues are also located in the areas targeted by radiations. In this study, we aimed to examine the bone mineral density changes in bone structures commonly included in the irradiated area such as, L5 vertebra, sacrum, and femur heads, in patients who have received pelvic radiotherapy; and the relationship between these changes with radiation dose.
Patients included in the study had been previously diagnosed with rectal cancer, which were operated or not. Preoperative or postoperative pelvic radiotherapy was planned for all patients. In terms of convenience when comparing with future scans, all densitometry and CT scans were performed with the same devices. Fifteen patients were included in the study. In order to determine the dose of radiation each identified area had taken after radiotherapy, the sacrum, L5 vertebra, bilateral femoral heads, and L1 regions were contoured in the CT scans in which treatment planning was done. Sagittal cross-sectional images were taken advantage of while these regions were being contoured.
Bone mineral density was evaluated with CT and dual-energy X-ray absorptiometry before and after the treatment. The regions that have theoretically been exposed to irradiation, such as L5, sacrum, left to right femur were found to have significant difference in terms of bone density. According to CT evaluation, there was a significant decrease in bone intensity of L5, sacrum, left and right femurs. Dual-energy X-ray absorptiometry assessment revealed that the whole of the left femoral head, left femur neck and Ward's region were significantly affected by radiotherapy. However, there was no significant difference in the sacrum and L5 vertebra before and after radiotherapy.
More accurate results could be achieved if the same study was conducted on a larger patient population, with a longer follow-up period. When the reduction in bone density is at maximum or a cure is likely in a long-term period, bone mineral density could be determined by measurements performed at regular intervals.
La radiothérapie est une méthode de traitement réalisée à l’aide de rayonnements ionisants chez des patients atteints de cancer, soit utilisée seule, soit dans le cadre d’une prise en charge par chirurgie ou par chimiothérapie. Bien que les techniques modernes de radiothérapie soient un avantage important pour la protection des tissus sains, il est inévitable que les tissus normaux soient également situés dans les zones visées par la radiothérapie. Dans cette étude, nous avons examiné les modifications de la densité minérale dans les structures osseuses communément incluses dans le volume de la radiothérapie pelvienne, telles que la vertèbre L5, le sacrum et les têtes de fémur et la relation entre ces changements avec la dose de rayonnement.
Les patients inclus dans l’étude étaient atteints d’un cancer du rectum, opéré ou non. Une radiothérapie pelvienne préopératoire ou postopératoire a été planifiée pour tous les patients. Les analyses tomodensitométriques ont été réalisées avec les mêmes appareils. Quinze patients ont été inclus dans l’étude. Afin de déterminer la dose délivrée de rayonnement, les régions du sacrum, de la vertèbre L5, de la tête fémorale bilatérale et de la vertèbre L1 ont été délinéées. Des images en coupes sagittales ont été exploitées pour cela.
L’intensité minérale osseuse a été évaluée par tomodensitométrie et dual-energy X-ray absorptiometry avant et après le traitement. Les régions exposées à l’irradiation comme la vertèbre L5, le sacrum, les fémurs gauche et droit, ont montré une différence significative en termes de densité osseuse. Selon l’évaluation par tomodensitométrie, il y avait diminution significative de la densité de l’os jusqu’à la vertèbre L5, le sacrum, les fémurs gauche et droit. L’évaluation par dual-energy X-ray absorptiometry a révélé que l’ensemble de la tête fémorale gauche, du col du fémur gauche et de la région de Ward étaient significativement affectés par la radiothérapie. Cependant, pour le sacrum et la vertèbre L5, il n’y avait pas de différence significative avant et après la radiothérapie.
Des résultats plus précis pourraient être obtenus si la même étude était menée dans une population de patients plus importante, avec une période de suivi plus longue. Lorsque la réduction de la densité osseuse est maximale ou qu’il y a une probabilité de guérison à long terme, elle peut être déterminée par des mesures de densité effectuées à intervalles réguliers.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>31331841</pmid><doi>10.1016/j.canrad.2019.05.014</doi><tpages>8</tpages></addata></record> |
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| ispartof | Cancer radiothérapie, 2019-09, Vol.23 (5), p.408-415 |
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| source | ScienceDirect Journals |
| subjects | Bone Cancer Density Densité Pelvic Pelvien Radiotherapy Radiothérapie Rectum |
| title | Investigation of differences of sacral and vertebral bone mineral densities before and after radiotherapy in patients with locally advanced rectal cancer |
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