How does avascular necrosis of the femoral head affect definitive radiation to the prostate?
Assume MRI noted this on exam and patient is minimally symptomatic.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · UC San Diego
Answered on
I asked the question and have no long-term follow-up to draw on to answer it. For what it is worth, I will summarize below what I learned from discussion with one experienced orthopedic surgeon, plus some reading. If others have insight/comments/opinions, please share!
- AVN is irreversible. Risk factors include steroid use and alcohol (also increased risk with several underlying conditions).
- Nonsurgical management should be tried for patients with tolerable pain, but it is often unsuccessful.
- My surgeon consultant says he has never heard that prostate radiation could cause AVN and does not believe it is a significant risk, given the low dose the hip receives with modern IMRT. This is consistent with what we know about osteonecrosis in head...
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Mednet Member
Radiation Oncology · Karmanos Cancer Institute - McLaren Proton Therapy Center
Answered on
Don't forget brachy, no entrance dose through hips, and falloff occurs rapidly as the square of distance from the HDR source.
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