48 THREE DIMENTIONAL EXTERNAL BEAM RADIOTHERAPY FOR PROSTATE CANCER INCREASES THE RISK OF HIP FRACTURE (2010)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 201048 THREE DIMENTIONAL EXTERNAL BEAM RADIOTHERAPY FOR PROSTATE CANCER INCREASES THE RISK OF HIP FRACTURE Shaheen Alanee, Stephanie Jarosek, Beth Virnig, and Sean Elliott Shaheen AlaneeShaheen Alanee Minneapolis, MN More articles by this author , Stephanie JarosekStephanie Jarosek Minneapolis, MN More articles by this author , Beth VirnigBeth Virnig Minneapolis, MN More articles by this author , and Sean ElliottSean Elliott Minneapolis, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.094AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hip fracture results in high morbidity and mortality. External beam radiotherapy is associated with hip fractures in women. Three dimensional external beam radiotherapy (3D-EBRT) is frequently used in the treatment of prostate cancer. We tested the hypothesis that pelvic 3D-EBRT is a risk factor for hip fractures but not fractures outside the radiation field in men with prostate cancer. To do this we compared the cumulative incidence of hip and wrist fractures in men treated with 3D-EBRT. METHODS 260,628 men 66 years of age and older, diagnosed with prostate cancer 1992-2005 were identified from the SEER-Medicare database. The primary outcome of hip fracture risk was compared among men who received 3D-EBRT to those who did not controlling for the use of androgen suppression therapy (AST), age, osteoporosis, race and other comorbidities measured by the Charlson comoribidity index. A secondary outcome was wrist fractures as an example of another fall-induced osteoporotic fracture outside the radiation field. RESULTS 3D-EBRT increased the risk of hip fractures by about 70% (OR 1.724, CI 1.355-2.194, P<0.0001) without increasing the risk of wrist fractures (OR 1.424, CI 0.494-4.103, P=0.5124). AST doubled the risk of hip and wrist fractures. Likewise, age and co morbidities increased the risk of both fractures. Combination therapy with 3D-EBRT and AST increased the risk of hip fracture above that of either treatment alone but a negative interaction blunted any multiplicative effect (OR 2.375, CI 2.173- 2.595, P<0.0001). CONCLUSIONS 3D-EBRT is a risk factor for hip fractures. Patients treated with 3D-EBRT for prostate cancer could benefit from measure to improve bone health, just as we are doing with AST, to decrease the risk of this high morbidity and mortality complication. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e20 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shaheen Alanee Minneapolis, MN More articles by this author Stephanie Jarosek Minneapolis, MN More articles by this author Beth Virnig Minneapolis, MN More articles by this author Sean Elliott Minneapolis, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...