Skeletal sequelae of radiation therapy for malignant childhood tumors

Journal Article · Thu Feb 01 04:00:00 EST 1990 · Clinical Orthopaedics and Related Research; (USA)

DOI:https://doi.org/10.1097/00003086-199002000-00039· OSTI ID:6983361

Butler, M S; Robertson, Jr, W W; Rate, W; D'Angio, G J; Drummond, D S ^[1]

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1. UMDNJ Robert Wood Johnson Medical School, New Brunswick (USA)

One hundred forty-three patients who received radiation therapy for childhood tumors, and survived to the age of skeletal maturity, were studied by retrospective review of oncology records and roentgenograms. Diagnoses for the patients were the following: Hodgkin's lymphoma (44), Wilms's tumor (30), acute lymphocytic leukemia (26), non-Hodgkin's lymphoma (18), Ewing's sarcoma (nine), rhabdomyosarcoma (six), neuroblastoma (six), and others (four). Age at the follow-up examination averaged 18 years (range, 14-28 years). Average length of follow-up study was 9.9 years (range, two to 18 years). Asymmetry of the chest and ribs was seen in 51 (36%) of these children. Fifty (35%) had scoliosis; 14 had kyphosis. In two children, the scoliosis was treated with a brace, while one developed significant kyphosing scoliosis after laminectomy and had spinal fusion. Twenty-three (16%) patients complained of significant pain at the radiation sites. Twelve of the patients developed leg-length inequality; eight of those were symptomatic. Three patients developed second primary tumors. Currently, the incidence of significant skeletal sequelae is lower and the manifestations are less severe than reported in the years from 1940 to 1970. The reduction in skeletal complications may be attributed to shielding of growth centers, symmetric field selection, decreased total radiation doses, and sequence changes in chemotherapy.

• OSTI ID: 6983361
• Journal Information: Clinical Orthopaedics and Related Research; (USA), Journal Name: Clinical Orthopaedics and Related Research; (USA) Vol. 251; ISSN 0009-921X; ISSN CORTB
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
DELAYED RADIATION EFFECTS
DISEASES
HEMIC DISEASES
IMMUNE SYSTEM DISEASES
INJURIES
LEUKEMIA
LYMPHOMAS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
PATIENTS
RADIATION EFFECTS
RADIATION INJURIES
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SKELETAL DISEASES
THERAPY