{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:04:05Z","timestamp":1784707445505,"version":"3.55.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the correlation between clinical and dosimetric factors and the incidence of pelvic insufficiency fractures (PIFs) in patients with cervical cancer treated with radical radiotherapy (RT), with or without chemotherapy, and to identify dose constraints that may reduce this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>\n                      We reviewed data from cervical cancer patients treated with pelvic external-beam RT at our institution between 2020 and 2023. For each patient, pelvic bone marrow (BM) was contoured and divided into three subsites: lumbosacral spine (LSBM), ilium (IBM), and lower pelvis (LPBM). Data on the volume of each region receiving 10, 20, 30,\u00a0and 40\u202fGy (V10, V20, V30, and V40, respectively) and D\n                      <jats:sub>mean<\/jats:sub>\n                      were collected.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A\u00a0total of 202 patients were retrospectively analyzed. Of these, 36 patients (17.8%) developed PIFs in the treatment field, with most cases being asymptomatic. Our analysis indicates that V40 of the LPBM is the most significant dosimetric parameter. When combined with patient age, this parameter stratifies the risk of fracture development according to the V40 value, thereby accounting for the patient\u2019s age in the risk assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This preliminary study allowed us to identify the dose constraints to reduce the risk of PIF according to patient age. Further investigations are needed to confirm these findings by including these parameters in the planning process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-026-02518-z","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:56:12Z","timestamp":1779382572000},"page":"888-894","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pelvic insufficiency fractures in cervical cancer patients treated with definitive chemoradiation: impact of dosimetric and clinical factors"],"prefix":"10.1007","volume":"202","author":[{"given":"Rosa","family":"Autorino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5133-8507","authenticated-orcid":false,"given":"Raffaella Michela","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Cusumano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Gui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"De Luca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Giannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Campitelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Lancellotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Bizzarri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonietta","family":"Gambacorta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"issue":"6","key":"2518_CR1","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1007\/s00428-018-2362-9","volume":"472","author":"D Cibula","year":"2018","unstructured":"Cibula\u00a0D, Potter\u00a0R, Planchamp\u00a0F, Avall-Lundqvist\u00a0E, Fischerova\u00a0D, Haie-Meder\u00a0C et\u00a0al (2018) The European Society of Gynaecological Oncology\/European Society for Radiotherapy and Oncology\/European Society of pathology guidelines for the management of patients with cervical cancer. 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Approval was granted by the Territorial Ethics Committee Lazio Area\u00a03\u2014Rome (Date 11.04.2024\/ ID 6447).","order":2,"name":"Ethics","label":"Ethical standards","group":{"name":"EthicsHeading","label":"Declarations"}}]}}