Systematic Review on Multilevel Analysis of Radiation Effects on Bone Microarchitecture

Abstract

Introduction. Modern radiation therapy has become an effective method to treat and monitor tumour growth in cancer patients. It has proved to be a successful way to minimise mortality rates. However, the adverse effects of radiation have been historical evidence in the clinical environment involving diminishing the quality and density of bone and causing fragility fracture to the bone in the long run. This systematic review was aimed at identifying and evaluating the effects of irradiation on morphology and mechanical properties of murine model bone in previous publications. Methods. A systematic literature review was undertaken following the Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA) guidelines. A comprehensive literature search was performed using Scopus, Web of Science, and Science Direct databases (English only studies published between 2015 and 2020). The selected studies were evaluated according to three criteria: (1) criteria for study sample selection; (2) criteria for methodological procedures; and (3) criteria for detection and evaluation. Results. The initial search strategy identified 1408 related studies, 8 of were included based on inclusion and exclusion criteria. This review revealed an association between bone destruction and the magnitude of time and dose postirradiation. We agreed that the effect of radiation on bone morphology and strength primarily is a later stage event but noticeable in both low (1 Gy) and high dose (30 Gy) radiation. Trabecular and cortical bone microstructures were significantly altered at irradiation and contralateral sites. Besides, the mechanical strength was significantly impacted in both shorter and longer periods. Conclusion. Overall, the radiotherapy altered bone microstructures and substantially decreases bone mechanical properties. The alteration was related to quantity and the activity of the osteoblast and osteoclast. Early detection of those most at risk for radiation-induced bone alterations could lead to better prophylactic intervention decisions.

The effects of high-dose radiation therapy on bone: a scoping review

“…RT doses cause damage to the structural integrity of bones. Bakar et al [14] performed a meta-analysis of eight studies on mice, rats and rabbits between 2015 and 2020 looking at the morphologic changes of bone, such as loss of bone density, after radiation. They concluded that the available studies showed damage from the RT that increased with dose and time from irradiation, and there was a bystander effect on the unirradiated bones.…”

“…Therapeutic doses of radiation also decrease the strength of bones. Bakar et al 's meta-analysis [14] also looked at the effect of RT on bone strength. They stated that the mechanical strength was significantly reduced by higher dose irradiation both shortly after and long after the irradiation.…”

Medical Protection of the Population and the Military at the Threat of Radioactive Contamination

“…Окрім того, механічна міцність зазнала значного впливу протягом як короткого, так і тривалого періодів. Найбільша радіочутливість скелетної тканини характерна для ембріонального періоду (38-85 доба внутрішньоутробного розвитку) [21].…”

Review of the Pathogenesis, Diagnosis, and Management of Osteoradionecrosis of the Femoral Head

“…Radiation therapy has been reported to have the adverse effect of reducing bone quality and density, leading to bone fragility and fractures in the long term. More than 65% of women treated for various pelvic tumors experience hip complications 5 years after RT [ 12 ].…”