INCIDENCE AND POSSIBLE ETIOLOGIC FACTORS IN THE DEVELOPMENT OF PELVICINSUFFICIENCY FRACTURES FOLLOWING RADICAL RADIOTHERAPY

Five patients out of a total of 183 treated with radical radiotherapy for carcinoma of cervix at The Royal Marsden Hospital from 1991 to 199 4 inclusive have developed severe pelvic fractures. Two patients had r heumatoid arthritis, one of whom died as a result of the radiation ind uced damage. This patient developed radiological evidence of radionecr osis within 1 month of completing radiotherapy. There are very few rep orts in the literature of such a rapid onset. We suggest that the pres ence of a connective tissue disorder in a patient with other risk fact ors such as steroid use, old age and osteopenia should alert the clini cian to the risk of radionecrosis following radical irradiation.