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Title: EFFECT OF RADIATION ON THE DEVELOPMENT OF FACIAL STRUCTURES IN RETINOBLASTOMA CASES

Abstract

Radiation injuries occurring as a result of treatment of the eye tumors in children irradiated at this hospital between 1944 and 1950 are reported. The findings presented an opportunity to study extensively the effect of radiation on the growth of the face. Eleven children showed marked stunting effect of the mid- section of the face, and later required corrective surgical procedure. In this group, the eye lesions were discovered at the age of seven weeks to two years of age, and radiation in combination with enucleation was administered at ages varying from two months to six years. The radiation was given through the temporal and nasal ports at doses which varied from 6800 to 8800 r (most patients received 8000 r or more at each port). The effects of radiation fall into two general categories; radiation dermatitis of soft tissue at the area of temporal and nasal ports; and retardation of growth of the mid-section of the face in the area of the orbits and the bridge of the nose, resulting in a unique appearance of the face, which is so characteristic that all the patients studied bear a strong resemblance to each other, as if they were siblings. Themore » radiation- induced changes of skin and soft tissue of temporal and nasal areas are characterized by thinning and atrophy of the skin and subcutaneous tissue. Typical radiation dermatitis, with absence of skin appendages and signs of keratosis and telangectasia of the skin vessels, is confined only to the precise areas where the special cones were applied. No malignant changes of the skin were noted in these 11 patients. The deformities of bone, which are described in detail, are so uniform that they can almost be recognized as constituting a syndrome. Recommended surgical procedures for these patients who survived radiotherapy and enucleation are suggested. Radiation dermatitis is a precancerous condition, and in other patients in the retinoblastoma series, basal cell or squamous cell carcinoma of the radiated areas developed. The surgical procedures, described in detail and illustrated, eradicate only the irradiated soft tissue and skin. From a theoretical viewpoint all the radiated bony tissue and paranasal sinuses should be removed surgically as a preventive measure. However, this would entail extensive destruction of the midsection of the face, and is so mutilating as to be unfeasible. (BBB)« less

Authors:
; ;
Publication Date:
Research Org.:
Columbia-Presbyterian Medical Center, New York
Sponsoring Org.:
USDOE
OSTI Identifier:
4122247
NSA Number:
NSA-18-011659
Resource Type:
Journal Article
Journal Name:
American Journal of Surgery (U.S.)
Additional Journal Information:
Journal Volume: Vol: 106; Other Information: Orig. Receipt Date: 31-DEC-64
Country of Publication:
Country unknown/Code not available
Language:
English
Subject:
BIOLOGY AND MEDICINE; AGE; BLOOD VESSELS; BONES; CARCINOGENESIS; EYES; MAN; RADIATION DOSES; RADIATION INJURIES; RADIOTHERAPY; SKIN; SURGERY; TISSUES; TUMORS

Citation Formats

Ju, D M.C., Moss, M, and Crikelair, G F. EFFECT OF RADIATION ON THE DEVELOPMENT OF FACIAL STRUCTURES IN RETINOBLASTOMA CASES. Country unknown/Code not available: N. p., 1963. Web. doi:10.1016/0002-9610(63)90406-9.
Ju, D M.C., Moss, M, & Crikelair, G F. EFFECT OF RADIATION ON THE DEVELOPMENT OF FACIAL STRUCTURES IN RETINOBLASTOMA CASES. Country unknown/Code not available. https://doi.org/10.1016/0002-9610(63)90406-9
Ju, D M.C., Moss, M, and Crikelair, G F. 1963. "EFFECT OF RADIATION ON THE DEVELOPMENT OF FACIAL STRUCTURES IN RETINOBLASTOMA CASES". Country unknown/Code not available. https://doi.org/10.1016/0002-9610(63)90406-9.
@article{osti_4122247,
title = {EFFECT OF RADIATION ON THE DEVELOPMENT OF FACIAL STRUCTURES IN RETINOBLASTOMA CASES},
author = {Ju, D M.C. and Moss, M and Crikelair, G F},
abstractNote = {Radiation injuries occurring as a result of treatment of the eye tumors in children irradiated at this hospital between 1944 and 1950 are reported. The findings presented an opportunity to study extensively the effect of radiation on the growth of the face. Eleven children showed marked stunting effect of the mid- section of the face, and later required corrective surgical procedure. In this group, the eye lesions were discovered at the age of seven weeks to two years of age, and radiation in combination with enucleation was administered at ages varying from two months to six years. The radiation was given through the temporal and nasal ports at doses which varied from 6800 to 8800 r (most patients received 8000 r or more at each port). The effects of radiation fall into two general categories; radiation dermatitis of soft tissue at the area of temporal and nasal ports; and retardation of growth of the mid-section of the face in the area of the orbits and the bridge of the nose, resulting in a unique appearance of the face, which is so characteristic that all the patients studied bear a strong resemblance to each other, as if they were siblings. The radiation- induced changes of skin and soft tissue of temporal and nasal areas are characterized by thinning and atrophy of the skin and subcutaneous tissue. Typical radiation dermatitis, with absence of skin appendages and signs of keratosis and telangectasia of the skin vessels, is confined only to the precise areas where the special cones were applied. No malignant changes of the skin were noted in these 11 patients. The deformities of bone, which are described in detail, are so uniform that they can almost be recognized as constituting a syndrome. Recommended surgical procedures for these patients who survived radiotherapy and enucleation are suggested. Radiation dermatitis is a precancerous condition, and in other patients in the retinoblastoma series, basal cell or squamous cell carcinoma of the radiated areas developed. The surgical procedures, described in detail and illustrated, eradicate only the irradiated soft tissue and skin. From a theoretical viewpoint all the radiated bony tissue and paranasal sinuses should be removed surgically as a preventive measure. However, this would entail extensive destruction of the midsection of the face, and is so mutilating as to be unfeasible. (BBB)},
doi = {10.1016/0002-9610(63)90406-9},
url = {https://www.osti.gov/biblio/4122247}, journal = {American Journal of Surgery (U.S.)},
number = ,
volume = Vol: 106,
place = {Country unknown/Code not available},
year = {1963},
month = {11}
}