Effect of abdominal irradiation on growth in boys treated for a wilms′ tumor
| Autor: | William Wallace, S. M. Shalet, Ric Swindell, P. H. Morris-Jones, H. R. Gattamaneni |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Adult
Male Cancer Research Flank Whole-Abdominal Irradiation Adolescent Growth Scoliosis Nephrectomy Wilms Tumor Radiotherapy High-Energy Abdomen medicine Humans Prospective Studies Child Rachis Leg business.industry Puberty Age Factors Infant Radiotherapy Dosage Wilms' tumor medicine.disease Body Height Kidney Neoplasms Spine medicine.anatomical_structure Oncology Child Preschool Pediatrics Perinatology and Child Health Complication business Nuclear medicine Kidney cancer |
| Zdroj: | Medical and Pediatric Oncology. 18:441-446 |
| ISSN: | 1096-911X 0098-1532 |
| Popis: | To study the effect of abdominal irradiation on spinal growth in childhood we have measured final height, sitting height, and leg length in 30 male survivors of a Wilms' tumor. Twenty-one patients received whole abdominal irradiation by either megavoltage therapy (MV: n = 11) or orthovoltage therapy (OV: n = 10); the remainder received flank irradiation. To examine the effect of the adolescent growth spurt on the irradiated spine we have followed prospectively seven patients who received whole abdominal irradiation and nine patients who received flank irradiation through puberty. Compared to a normal population there is a modest reduction in median final standing height SDS (H.SDS: -1.15) accompanied by a marked reduction in median final sitting height SDS (S.HT SDS: -2.41) with no apparent effect on median subischial leg length SDS (SILL.SDS: 0.04). This reduction in spinal growth is reflected by a strongly positive disproportion score (DPS; (SILL SDS-S.HT SDS) + 2.81). The incidence of scoliosis after abdominal irradiation has been low (10%). During puberty there is a significant fall in median sitting height SDS after both whole abdominal (median fall: -0.9, P = 0.02) and flank irradiation (median fall: -1.85, P = 0.01), and this is reflected in amore » significant increase in disproportion (DPS: whole abdominal; median rise +1.4, P = 0.02: flank, median rise +1.34, P = 0.01). After MV irradiation there is a significant correlation between the degree of disproportion and the age at treatment (P less than 0.0005). The younger the patient is at treatment the more severe is the restriction on spinal growth and the shorter and more disproportionate they become as an adult. The estimated eventual loss in potential height from abdominal irradiation at the age of one is 10 cm and at five years is 7 cm.« less |
| Databáze: | OpenAIRE |
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