88. Radiation Therapy-Induced Osteoporosis

  1. Clifford J. Rosen MD
  1. Jeffrey S. Willey,
  2. Shane A.J. Lloyd and
  3. Ted A. Bateman

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch88

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Willey, J. S., Lloyd, S. A.J. and Bateman, T. A. (2013) Radiation Therapy-Induced Osteoporosis, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch88

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • bone strength;
  • fractures;
  • osteoblasts;
  • osteoclasts;
  • osteocytes;
  • radiation therapy-induced osteoporosis;
  • vasculature

Summary

This review outlines the rationale for radiation-induced fractures as a clinical concern, as well as the current state of knowledge regarding in vivo and in vitro models of radiation therapy-induced osteoporosis. Damage to osteoblasts following irradiation has long been recognized as the greatest contributor to the development of reduced bone mineral density. Research over the past decade has highlighted the substantial role that osteoclasts play in radiation-induced osteoporosis. Irradiation results in increased osteoclast number and activity within the first few days after exposure. Skeletal fractures are known to be a late effect resulting from direct irradiation. These fractures are thought to result from radiation-induced deterioration of both bone quantity and quality. To date, the most direct assessment of radiation-induced reduction in bone strength comes from rodent and rabbit models, although studies are limited.