Slipped femoral capital epiphyses in irradiated children: dose, volume and age relationships

Journal Article · Thu Oct 01 04:00:00 EDT 1981 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(81)90031-6· OSTI ID:5708179

Silverman, C L; Thomas, P R.M.; McAlister, W H; Walker, S; Whiteside, L A

Between 1960 and 1979, 50 patients under 15 years of age received radiotherapy to the pelvis including the non-fused capital femoral epiphyseal plate. A total of 83 epiphyseal plates were at risk. Eight epiphyseal plates (9.6%) in five patients were abnormal: symptomatic capital femoral epiphyseal slippage--4, asymptomatic slippage--1, severe epiphyseal abnormalities of radiographs--3. No complication occurred below doses of 2,500 rad (25 Gy). Children under the age of 4 at time of irradiation were at a higher risk (7/15-47%) than those over 4 years of age (1/21-4.7%). Most slippages occurred at ages between 8 and 10 years. No dose response curve was obtained--higher doses above the threshold dose of 2,500 rad did not increase the incidence of slippage. A mechanism of action is postulated. This is a preventable complication; judicious use of primary or secondary blocking systems can eliminate or limit the dose to the non-fused epiphyseal plate and prevent later morbid complications.

• Research Organization: Washington Univ. School of Medicine, St. Louis, MO
• OSTI ID: 5708179
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 7:10; ISSN IOBPD
• Country of Publication: United States
• Language: English

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550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
AGE GROUPS
ANIMAL TISSUES
BODY
BODY AREAS
BONE TISSUES
CHILDREN
CONNECTIVE TISSUE
DOSES
FEMUR
IRRADIATION
MEDICINE
NUCLEAR MEDICINE
ORGANS
PATIENTS
PELVIS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SKELETON
THERAPY
TISSUES