[Somatic sequelae induced by radiotherapy in bone segments in adults]

Area of Science:

• Oncology
• Radiology
• Bone Pathology

Background:

• Bone sequelae are potential complications following radiation therapy.
• Understanding the factors contributing to these sequelae is crucial for patient management.

Purpose of the Study:

• To discuss the radiological features, differential diagnosis, and causes of bone sequelae after radiation.
• To analyze complications such as fractures and osteitis and their treatment outcomes.

Main Methods:

• Literature review and analysis of a personal case series.
• Evaluation of radiological findings, including sclerotic and atrophic changes.
• Correlation of bone alterations with radiation dose and chronological distribution (Nominal Standard Dose - NSD).

Main Results:

• Radiological findings include a combination of sclerotic and atrophic bone changes, predominantly atrophic in the mandible and cranial bones.
• Higher Nominal Standard Dose (NSD) values correlate with increased incidence and severity of bone alterations.
• Alterations are observed primarily after doses exceeding 1352 rets.
• Common complications include fractures and septic osteitis, especially in the mandible.

Conclusions:

• Radiation dose and distribution are key factors in the development of bone sequelae.
• Conservative treatment is often effective for fractures and osteitis, with spontaneous healing possible.
• Higher radiation doses may necessitate osteotomy, sometimes with suboptimal results.