# Incidence of pelvic fractures after definitive radiotherapy for cervical cancer: A retrospective multicenter cohort study (The IPFAR study)

## TL;DR

A study found that nearly 30% of cervical cancer patients who had radiotherapy developed pelvic fractures, with significant variation between hospitals.

## Contribution

The study identifies postmenopausal status and treating institution as independent risk factors for pelvic insufficiency fractures after cervical cancer radiotherapy.

## Key findings

- 28.4% of cervical cancer patients who received definitive radiotherapy developed pelvic insufficiency fractures.
- Postmenopausal status and treating institution were identified as independent risk factors for pelvic fractures.
- The incidence of fractures varied significantly between institutions, ranging from 18.9% to 50.0%.

## Abstract

This multicenter study aimed to identify the risk factors for pelvic insufficiency fractures (PIFs) in women who received definitive radiotherapy (RT) as the initial treatment for cervical cancer and to examine the differences in the incidence of PIFs across institutions.

The medical records of 208 women were reviewed. These women received definitive RT as an initial treatment for cervical cancer at four institutions between January 2016 and December 2018.

The median age was 61.5 years (range: 29–93 years). Overall, 59 patients (28.4%) developed PIF, with 48 (81.4%) of them developing it within two years after completion of RT. Multivariate analysis identified postmenopausal status and treating institution as independent risk factors. The incidence of PIF varied significantly among institutions, ranging from 18.9% to 50.0%, despite no significant differences in patient demographics or RT protocols.

Substantial inter-institutional variation in PIF incidence was observed, even under standardized treatment conditions. These findings underscore the need for individualized risk assessment and institutional quality control in the long-term management of cervical cancer survivors.