Primary Versus Secondary Radiotherapy for Heterotopic Ossification Prevention About the Elbow.

Autor:	Geller JS; University of Miami Miller School of Medicine, Miami, FL; and., Allegra PR; Departments of Orthopedic Surgery, and., Seldon CS; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Spieler BO; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Cohen LL; University of Miami Miller School of Medicine, Miami, FL; and., Barnhill SW; Departments of Orthopedic Surgery, and., Huntley SR; Departments of Orthopedic Surgery, and., De La Zerda A; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Samuels S; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Wang L; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Isrow D; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Wolfson AH; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL., Yechieli RL; Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL.
Jazyk:	angličtina
Zdroj:	Journal of orthopaedic trauma [J Orthop Trauma] 2022 Feb 01; Vol. 36 (2), pp. e56-e61.
DOI:	10.1097/BOT.0000000000002188
Abstrakt:	Objectives: To examine the efficacy and safety of radiotherapy for the prevention of heterotopic ossification (HO) about the elbow. Design: Retrospective chart review. Setting: Level 1 trauma center. Patients/participants: Two hundred and twenty-nine patients who received prophylactic radiotherapy (XRT) over a 15-year period were identified. Patients were included if they received XRT to the elbow joint and had at least 12 weeks of follow-up after XRT. Fifty-four patients were ultimately included. Intervention: All patients were treated with a single dose of 7 Gy. Ninety-eight percentage of patients received XRT within 24 hours after surgery, and all patients received XRT within 72 hours after surgery. Main Outcomes Measurements: The primary study measures evaluated were the presence or absence of clinically symptomatic HO and the presence of radiographic HO after XRT to the elbow joint. Results: Eighteen patients were treated with XRT after a traumatic injury requiring surgery (primary prophylaxis), and 36 were treated with XRT after excision surgery to remove HO which had already formed (secondary prophylaxis). In the primary cohort, 16.7% developed symptomatic HO after XRT and 11.1% required surgery to resect the heterotopic bone. In the secondary cohort, 11.1% developed symptomatic HO after surgery and XRT and 5.5% required resection surgery. No secondary malignancies were identified. Conclusions: Our findings suggest that XRT for elbow HO may be safe and effective for both primary and secondary HO. XRT for HO was not shown to be associated with radiation-induced sarcoma in this series, at least in the short term. Further study in a large patient population with extended follow-up is required to better characterize populations at high risk for development of HO and secondary malignancy. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. Competing Interests: The authors report no conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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