Fractures of thoracic vertebrae in patients with locally advanced non-small cell lung carcinoma treated with intensity modulated radiotherapy

PurposeTo report on the incidence of vertebral fractures in patients treated with Intensity Modulated Radiotherapy (IMRT) for locally advanced non-small cell lung carcinoma (NSCLC) and to analyse the association with clinical and dosimetric parameters.Patients and methodsBetween 2007 and 2012, 524 patients treated with ⩾51 Gy were retrospectively analysed for the incidence of vertebral fractures (VF). Clinical parameters were assessed. In addition, a case control study in 50 patients was performed to study the association between the radiotherapy dose and fractured vertebrae.ResultsThree hundred and thirty-six patients were eligible for analyses. Twenty-eight patients (8%) were observed with VF at a median follow up of 12 months. Age was significantly higher in the group with VF (p < 0.01). After balancing age, the mean vertebrae dose was most significantly associated with fractures of the vertebrae (p < 0.01).ConclusionVF was observed in 8% of the patients with locally advanced NSCLC. RT dose was associated with the occurrence of thoracic vertebral fractures.