{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:08:28Z","timestamp":1773709708715,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2011,3,16]],"date-time":"2011-03-16T00:00:00Z","timestamp":1300233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Hip fracture is associated with high morbidity and mortality. Pelvic external beam radiotherapy (EBRT) is known to increase the risk of hip fractures in women, but the effect in men is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>From the Surveillance, Epidemiology, and End Results (SEER)\u2010Medicare database, 45,662 men who were aged \u226566 years and diagnosed with prostate cancer in 1992\u20102004 were identified. By using Kaplan\u2010Meier methods and Cox proportional hazards models, the primary outcome of hip fracture risk was compared among men who received radical prostatectomy (RP), EBRT, EBRT plus androgen suppression therapy (AST), or AST alone. Age, osteoporosis, race, and other comorbidities were statistically controlled. A secondary outcome was distal forearm fracture as an indicator of the risk of fall\u2010related fracture outside the radiation field.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>After covariates were statistically controlled, the findings showed that EBRT increased the risk of hip fractures by 76% (hazards ratio [HR], 1.76; 95% confidence interval [CI], 1.38\u20102.40) without increasing the risk of distal forearm fractures (HR, 0.80; 95% CI, 0.56\u20101.14). Combination therapy with EBRT plus AST increased the risk of hip fracture 145% relative to RP alone (HR, 2.45; 95% CI, 1.88\u20103.19) and by 40% relative to EBRT alone (HR, 1.40; 95% CI, 1.17\u20101.68). EBRT plus AST increased the risk of distal forearm fracture by 43% relative to RP alone (HR, 1.43; 95% CI, 0.97\u20102.10). The number needed to treat to result in 1 hip fracture during a 10\u2010year period was 51 patients (95% CI, 31\u2010103).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>In men with prostate cancer, pelvic 3\u2010D conformal EBRT was associated with a 76% increased risk of hip fracture. This risk was slightly increased further by the addition of short\u2010course AST to EBRT. This risk associated with EBRT must be site\u2010specific as there was no increase in the risk of fall\u2010related fractures in bones that were outside the radiation field. Cancer 2011. \u00a9 2011 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.25994","type":"journal-article","created":{"date-parts":[[2011,3,16]],"date-time":"2011-03-16T09:38:34Z","timestamp":1300268314000},"page":"4557-4565","source":"Crossref","is-referenced-by-count":50,"title":["Three\u2010dimensional external beam radiotherapy for prostate cancer increases the risk of hip fracture"],"prefix":"10.1002","volume":"117","author":[{"given":"Sean P.","family":"Elliott","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie L.","family":"Jarosek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaheen R.","family":"Alanee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badrinath R.","family":"Konety","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn E.","family":"Dusenbery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth A.","family":"Virnig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,3,16]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)09075-8"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(97)90022-X"},{"key":"e_1_2_6_4_2","first-page":"193","article-title":"Diagnosis and treatment of osteoporosis","volume":"79","author":"Sweet MG","year":"2009","journal-title":"Am Fam Physician."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.01954.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.20.2587"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-007-0429-6"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10338"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199512000-00006"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002560050200"},{"key":"e_1_2_6_11_2","unstructured":"The authors' unpublished analysis of the SEER public use file."},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.0133"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-10-152"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)09408-4"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0810095"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.02.094"},{"key":"e_1_2_6_17_2","article-title":"NCIC CTG PR.3\/ MRC PRO7\/ SWOG JPR3 investigators. Intergroup randomized phase III study of androgen deprivation therapy (ADT) plus radiation therapy (RT) in locally advanced prostate cancer (CaP) (NCIC\u2010CTG, SWOG, MRC\u2010UK, INT: T94\u20130110; NCT00002633) [abstract]. Presented at the American Society of Clinical Oncology Annual Meeting, June 4\u20108, 2010, Chicago, Il","volume":"28","author":"Warde PR","year":"2010","journal-title":"J Clin Oncol."},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00256-0"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02305759"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-199406000-00015"},{"key":"e_1_2_6_21_2","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1302\/0301-620X.77B6.7593093","article-title":"Total hip replacement in irradiated hips. A retrospective study of 71 cases","volume":"77","author":"Massin P","year":"1995","journal-title":"J Bone Joint Surg Br."},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0958-3947(01)00079-6"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041943"},{"issue":"8","key":"e_1_2_6_24_2","article-title":"Measuring complications of cancer treatment using the SEER\u2010Medicare data","volume":"40","author":"Potosky AL","year":"2002","journal-title":"Med Care."},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000059281.67667.97"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970201)79:3<545::AID-CNCR17>3.0.CO;2-3"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.25994","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.25994","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T10:30:30Z","timestamp":1760265030000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.25994"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,3,16]]},"references-count":25,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2011,10]]}},"alternative-id":["10.1002\/cncr.25994"],"URL":"https:\/\/doi.org\/10.1002\/cncr.25994","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,3,16]]}}}