Pilot Study: Short Term Impact of Radiation Therapy on Bone Mineral Density and Bone Metabolism

作者：Quirina C. B. S. Thio, Olivier D. R. van Wulfften Palthe, Jos A. M. Bramer, Thomas F. DeLaney, Miriam A. Bredella, David W. Dempster, Hua Zhou, Francis J. Hornicek, Yen-Lin E. Chen, Joseph H. Schwab · 发表于：Calcified Tissue International · 年份：2023 · DOI：10.1007/s00223-023-01149-1 · 被引用次数：7 · 研究领域：Management of metastatic bone disease、Bone health and treatments、Bone and Joint Diseases

Abstract Despite the risk of complications, high dose radiation therapy is increasingly utilized in the management of selected bone malignancies. In this study, we investigate the impact of moderate to high dose radiation (over 50 Gy) on bone metabolism and structure. Between 2015 and 2018, patients with a primary malignant bone tumor of the sacrum that were either treated with high dose definitive radiation only or a combination of moderate to high dose radiation and surgery were prospectively enrolled at a single institution. Quantitative CTs were performed before and after radiation to determine changes in volumetric bone mineral density (BMD) of the irradiated and non-irradiated spine. Bone histomorphometry was performed on biopsies of the irradiated sacrum and the non-irradiated iliac crest of surgical patients using a quadruple tetracycline labeling protocol. In total, 9 patients were enrolled. Two patients received radiation only (median dose 78.3 Gy) and 7 patients received a combination of preoperative radiation (median dose 50.4 Gy), followed by surgery. Volumetric BMD of the non-irradiated lumbar spine did not change significantly after radiation, while the BMD of the irradiated sacrum did (pre-radiation median: 108.0 mg/cm 3 (IQR 91.8–167.1); post-radiation median: 75.3 mg/cm 3 (IQR 57.1–110.2); p = 0.010). The cancellous bone of the non-irradiated iliac crest had a stable bone formation rate, while the irradiated sacrum showed a significant decrease in bone forma...