Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects
Abstract Background Surgical resection is the primary treatment for advanced-stage heterotopic ossification (HO), with a high incidence of local recurrence reaching up to 50%. Postoperative radiotherapy (PORT) and indomethacin are commonly used prophylactic strategies following surgery. The study ai...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-11-01
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| Series: | Journal of the Egyptian National Cancer Institute |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43046-022-00149-w |
| _version_ | 1811304570328973312 |
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| author | Reham Mohamed Asif Iqbal Abosaleh Abosaleh Elawadi |
| author_facet | Reham Mohamed Asif Iqbal Abosaleh Abosaleh Elawadi |
| author_sort | Reham Mohamed |
| collection | DOAJ |
| description | Abstract Background Surgical resection is the primary treatment for advanced-stage heterotopic ossification (HO), with a high incidence of local recurrence reaching up to 50%. Postoperative radiotherapy (PORT) and indomethacin are commonly used prophylactic strategies following surgery. The study aims to assess the safety and effectiveness of PORT in advanced-stage HO patients having motor vehicle accidents (MVA). Methods Medical records of patients having HO following MVA between 2006 and 2021 were retrospectively reviewed. Thirty-nine patients with advanced disease (35 had hip HO and 4 had elbow HO) were included in the study. Results Excision of HO with joint preservation was performed for 82% of patients, while 18% had a joint replacement. Seven to 8 Gy radiation was given to all patients within 3 days postoperatively. A ninty seven percent of patients regained partially the movement range. The mean follow-up time was 74 months. Six patients had treatment failure, with only one having a recurrence of HO. The 8-year treatment failure-free rate (8-y TFFR) was 79.3±9%, and the 5-year HO failure-free rate (5y-HOFFR) was 97.2±3%. Acute side effects were experienced in 13% of patients but resolved without any consequences. Despite the relatively long follow-up time, we did not report any absolute infertility or secondary malignancies related to the radiation. The testicular mean calculated dose was 33±44 cGy, and the mean measured dose was 58±40 cGy. Of the 35 patients who received radiation to the pelvis, 26 were married, and all did not experience infertility post-treatment. Conclusion PORT proved an effective and safe treatment for advanced-stage HO disease. The treatment failure is mainly related to surgical difficulties due to advanced disease. Treatment using a 3-dimensional or intensity-modulated radiation therapy is not associated with serious side effects like second malignancy or absolute infertility. |
| first_indexed | 2024-04-13T08:09:34Z |
| format | Article |
| id | doaj.art-dc3c852026494d6eb2297c33404f38fa |
| institution | Directory Open Access Journal |
| issn | 2589-0409 |
| language | English |
| last_indexed | 2024-04-13T08:09:34Z |
| publishDate | 2022-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian National Cancer Institute |
| spelling | doaj.art-dc3c852026494d6eb2297c33404f38fa2022-12-22T02:55:03ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092022-11-013411910.1186/s43046-022-00149-wFifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effectsReham Mohamed0Asif Iqbal1Abosaleh Abosaleh Elawadi2National Cancer Institute, Radiotherapy and Nuclear Medicine Department, Cairo UniversityMedical Physics Department Riyadh, King Fahad Medical CityMedical Physics Department Riyadh, King Fahad Medical CityAbstract Background Surgical resection is the primary treatment for advanced-stage heterotopic ossification (HO), with a high incidence of local recurrence reaching up to 50%. Postoperative radiotherapy (PORT) and indomethacin are commonly used prophylactic strategies following surgery. The study aims to assess the safety and effectiveness of PORT in advanced-stage HO patients having motor vehicle accidents (MVA). Methods Medical records of patients having HO following MVA between 2006 and 2021 were retrospectively reviewed. Thirty-nine patients with advanced disease (35 had hip HO and 4 had elbow HO) were included in the study. Results Excision of HO with joint preservation was performed for 82% of patients, while 18% had a joint replacement. Seven to 8 Gy radiation was given to all patients within 3 days postoperatively. A ninty seven percent of patients regained partially the movement range. The mean follow-up time was 74 months. Six patients had treatment failure, with only one having a recurrence of HO. The 8-year treatment failure-free rate (8-y TFFR) was 79.3±9%, and the 5-year HO failure-free rate (5y-HOFFR) was 97.2±3%. Acute side effects were experienced in 13% of patients but resolved without any consequences. Despite the relatively long follow-up time, we did not report any absolute infertility or secondary malignancies related to the radiation. The testicular mean calculated dose was 33±44 cGy, and the mean measured dose was 58±40 cGy. Of the 35 patients who received radiation to the pelvis, 26 were married, and all did not experience infertility post-treatment. Conclusion PORT proved an effective and safe treatment for advanced-stage HO disease. The treatment failure is mainly related to surgical difficulties due to advanced disease. Treatment using a 3-dimensional or intensity-modulated radiation therapy is not associated with serious side effects like second malignancy or absolute infertility.https://doi.org/10.1186/s43046-022-00149-wHeterotopicOssificationRadiotherapyHipElbow |
| spellingShingle | Reham Mohamed Asif Iqbal Abosaleh Abosaleh Elawadi Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects Journal of the Egyptian National Cancer Institute Heterotopic Ossification Radiotherapy Hip Elbow |
| title | Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects |
| title_full | Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects |
| title_fullStr | Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects |
| title_full_unstemmed | Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects |
| title_short | Fifteen years’ experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents: outcome and side effects |
| title_sort | fifteen years experience of radiation therapy for resected advanced heterotopic ossification following motor vehicle accidents outcome and side effects |
| topic | Heterotopic Ossification Radiotherapy Hip Elbow |
| url | https://doi.org/10.1186/s43046-022-00149-w |
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