Clinicopathologic features and exploration of new molecular mechanisms of radiation-induced bone injury: report of two cases and review of the literature.

Radiation-induced bone injury (RBI) has a multifaceted mechanism of occurrence, is influenced by various factors, and is difficult to prevent. Clinicopathologic features and manifestations of disease progression were observed in two patients with distinct fractures: one with a left-sided fourth rib fracture after postoperative radiotherapy for lung cancer, and the other with a right-sided intertrochanteric femur fracture following accidental exposure to a ¹⁹²Ir radiation source 5 years prior. These two clinical case reports discussed the clinicopathologic features of RBI and disease progression and utilized transcriptome sequencing to explore potential new targets for treating this type of RBI. Both patients exhibited similar incurable osteolytic bone destruction and fatty infiltration in their pathology. It is proposed that XIST, the most significantly upregulated gene identified by transcriptome sequencing analysis, maybe a potential target for understanding these molecular mechanisms.