{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:13:49Z","timestamp":1790140429700,"version":"4.0.1"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP21K07661"],"award-info":[{"award-number":["JP21K07661"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Bone-modifying agents (BMAs) have been widely used to reduce skeletal-related events, including pathological fractures. Herein, we aimed to clarify the incidence of pathological fractures caused by high-risk femoral bone metastases after palliative radiotherapy (RT) in the BMA era and evaluate the necessity of prophylactic surgical stabilization. We assessed 90 patients with high-risk femoral bone metastases, indicated by Mirels\u2019 scores \u2265 8, without pathological fractures and surgical fixations, who received palliative RT at our institution between January 2009 and December 2018. Pathological fracture incidence was analyzed using the Kaplan\u2013Meier method and was 22.8% and 31.0% at 2 and 6 months, respectively. Pathological fractures were caused by 17 of 65 lesions (26.2%) and 9 of 25 lesions (36.0%) in patients who received BMAs and those who did not, respectively (p = 0.44). Additionally, 17 of 42 lesions (40.5%) and 9 of 48 lesions (18.8%) with axial cortical involvement \u226530 and &lt;30 mm, respectively, caused pathological fractures (p = 0.02). The incidence of pathological fractures was high among patients with high-risk femoral bone metastases treated with palliative RT, particularly those with axial cortical involvement \u226530 mm. Therefore, aggressive indications for prophylactic surgical stabilization are warranted for high-risk femoral metastases despite BMA administration.<\/jats:p>","DOI":"10.3390\/curroncol31120549","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T07:54:20Z","timestamp":1732262060000},"page":"7437-7444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["High Fracture Risk of Femoral Bone Metastasis Treated with Palliative Radiotherapy in Recent Years"],"prefix":"10.3390","volume":"31","author":[{"given":"Kenji","family":"Makita","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"},{"name":"Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama 791-0280, Ehime, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiro","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5600-0312","authenticated-orcid":false,"given":"Hidekazu","family":"Oyoshi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4431-8892","authenticated-orcid":false,"given":"Masaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyo","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yume","family":"Koike","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzheng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"Tomizawa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Fukushi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadamoto","family":"Zenda","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa 277-8577, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3322\/canjclin.48.1.6","article-title":"Cancer statistics, 1998","volume":"48","author":"Landis","year":"1998","journal-title":"CA Cancer J. 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