{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:56:07Z","timestamp":1785408967610,"version":"3.56.0"},"reference-count":52,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,5,18]],"date-time":"2019-05-18T00:00:00Z","timestamp":1558137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To determine whether radiotherapy (<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>) can increase pelvic fracture risk in rectal cancer survivors. Rectal cancer patients who underwent curative surgery between 1996 and 2011 in Taiwan were retrospectively studied using the National Health Insurance Research Database (<jats:styled-content style=\"fixed-case\">NHIRD<\/jats:styled-content>) of Taiwan. <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u20109 Codes 808, 805.4\u2010805.7, 806.4\u2010806.7, and 820 (including pelvic, sacrum, lumbar, and femoral neck fracture) were defined as pelvic fracture. Propensity scores for <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>, age, and sex were used to perform one\u2010to\u2010one matches between the <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> and non\u2010<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> group. Risks of pelvic and arm fractures were compared by multivariable Cox regression. Of the 32\u00a0689 patients, 7807 (23.9%) received <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>, and 1616 suffered from a pelvic fracture (incidence rate: 1.17\/100 person\u2010years). The median time to pelvic fracture was 2.47\u00a0years. After matching, 6952 patients each in the <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> and non\u2010<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> groups were analyzed. <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> was associated with an increased risk of pelvic fractures in the multivariable Cox model (hazard ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>): 1.246, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>): 1.037\u20101.495, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.019) but not with arm fractures (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 1.013, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.814\u20101.259, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.911). Subgroup analyses revealed that <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> was associated with a higher pelvic fracture rate in women (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 1.431, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.117\u20101.834) but not in men, and the interaction between sex and <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> was significant (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). The <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> of pelvic fracture increased 2\u20104\u00a0years after <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>: 1.707, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.150\u20102.534, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). An increased risk of pelvic fracture is noted in rectal cancer survivors, especially women, who receive <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>.<\/jats:p>","DOI":"10.1002\/cam4.2030","type":"journal-article","created":{"date-parts":[[2019,5,19]],"date-time":"2019-05-19T04:13:21Z","timestamp":1558239201000},"page":"3639-3647","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Increased risk of pelvic fracture after radiotherapy in rectal cancer survivors: A propensity matched study"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8833-7457","authenticated-orcid":false,"given":"Yu\u2010Mei","family":"Kang","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology Department of Oncology Taipei Veterans General Hospital Taipei 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