Table 2.

Summary of studies measuring incidence of pelvic insufficiency fractures (PIFs) among cancer patients receiving pelvic radiation therapy

Study	Era	No. patients	Median time to fracture/total follow-up	Median total dose (Gray)	Disease site	Study Incidencea	5-year actuarial incidenceb
Bazire et al. [72] 2017	2007–2014	341	11 mo./38 mo.	50.3	52% cervical 32% endometrial 16% anal	4.4% Radiographic (R)	Not given
						3.2% Symptomatic (S)
Shih et al. [73] 2013	2000–2008 37% IMRT	222	12 mo./47 mo.	50.4	65% endometrial 35% cervical	5.0% (R)	5.1% (R)
						3.2% (S)
Uezono et al. [74] 2013	2003–2009	99	14 mo./21 mo.	50.4	cervical	33% (R)	63% (R)
						20% (S)
Kim et al. [75] 2012	1998–2007	492	46 mo./42 mo.	50.4	rectal	7.1% sacral fracture (R)	Not given
Tokumaru et al. [76] 2012	2004–2007	59	not given/24 mo.	49	cervical	36%(R)	Not given
						15% (S)
Schmeler et al. [77] 2010	2001–2006 3% IMRT	300	14 mo./21 mo.	45	cervical	9.7% (R)	Not given
						4.3% (S)
Herman et al. [78] 2009	1989–2004	562	17 mo./49 mo.	45	rectal	2.7% sacral fracture (R)	Not given
						1.2% sacral fracture (S)
Oh et al. [79] 2008	1998–2005	557	13 mo./30 mo.	45	cervical	15%(R)	20% (R)
						8.6% (S)	11% (S)
Kwon et al. [80] 2008	1998–2005	510	17 mo./14 mo.	50.4	cervical	20% (R)	45% (R)
						8.4% (S)
Ikushima et al. [81] 2006	1993–2004	158	6 mo./43 mo.	45	96% cervical 4% endometrial	11% (S)	13% (S)
Baxter et al. [82] 2005	1986–1999	399 women age 65+	not given/47 mo.	Not given	anal	14% (unclear R/S)	14% (unclear R/S)
Ogino et al. [83] 2003	1983–1998	335 post-menopausal	8 mo./39 mo.	49.4	cervical	17% (R)	18% (S)
						14% (S)
Tai et al. [84] 2000	1991–1995	336	11 mo./29 mo.	Not given	endometrial vaginal	4.8% (S)	2.1% (S)

^aIncidence calculated over variable study period

^b5-year actuarial incidence calculated with Kaplan Meier analysis