Skeletal effects of megavoltage irradiation in survivors of Wilms' tumor

Dk, Heaston; Libshitz, HI; Chan, RC

doi:10.2214/ajr.133.3.389

Cited by 72 publications

(28 citation statements)

References 8 publications

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“…Even when the entire vertebral body is irradiated, deformity can still occur, but asymmetric irradiation is associated with more frequent and severe deformity [33]. Progression of scoliosis may be seen during the adolescent growth spurt [34]. The lower ribs and pelvis are often included in the same treatment port as the spine, resulting in hypoplasia (Fig.…”

Section: Immature Axial Skeletonmentioning

confidence: 99%

The effect of X-rays on bone: a pictorial review

2005

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The deleterious effects of X-rays on bone have been recognised for almost a century and continue to be seen today because of improved survival in patients treated for malignancy with radiotherapy with or without other treatments. In this pictorial review we present the imaging features of radiation damage to bone highlighting the differences seen in the immature skeleton and post-skeletal fusion. In the former, damage is greatest to the physis resulting in growth disturbances. In the mature skeleton there is a spectrum of changes from mild osteopenia, through disordered attempts at healing with varying degrees of sclerosis, radionecrosis which may lead to acute fractures following minimal trauma and insufficiency fractures both with refractory healing to the dreaded complication of sarcomatous transformation. The imaging appearances are illustrated and the features that help distinguish malignant change from other complications stressed.

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Section: Immature Axial Skeletonmentioning

confidence: 99%

The effect of X-rays on bone: a pictorial review

2005

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“…We did not record the maximum static respiratory pressures, recently described by De Troyer17 and requiring good motivation and cooperation from the subjects, but it is unlikely that respiratory muscle strength was decreased in subjects who were able to perform normal Pst. Skeletal radiation damage identical to the vertebral body changes seen after the kidney tumour bed irradiation is also possible.18 19 If thoracic hypoplasia, which increases with the passage of time, is caused by failure of chest-wall growth, this could explain the progressive diminution of lung volume but not the early functional changes.…”

Section: Measured Lung Functionmentioning

confidence: 99%

Effects of pulmonary function of whole lung irradiation for Wilm's tumour in children.

Benoist¹,

Lemerle²,

Jean³

et al. 1982

Thorax

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The effect of whole lung irradiation on lung function was investigated in 48 children treated for Wilm's tumour with pulmonary metastases. Lung function tests were performed before irradiation and were repeated annually for as long as possible, the length of follow-up varying from two to 17 years. A reduction in both lung volume and in dynamic compliance was clearly observed. In some patients these changes occurred in the early post-irradiation months, but in most the decrease observed progressed over longer periods of time. Static pressure volume curves, bloodgases, and carbon monoxide transfer were normal. These findings make it unlikely that postirradiation pulmonary fibrosis was involved. Another explanation for the decreased lung volume and dynamic compliance might be failure of alveolar multiplication. Muscular injury is unlikely as the patients were able to produce normal transthoracic pressures. A failure of chest wall growth is also possible and would explain the progressive restrictive impairment but not the early lung function changes. It is suggested that the early effects detected in some patients were the result of lung injury and that later effects resulted from impaired chest wall growth.Although the effects of pulmonary irradiation on lung function have been extensively investigated in adults, reports on the effects on respiratory function of whole lung irradiation are relatively few and there have been no reports of detailed, repeated lung function tests after this type of irradiation.In contrast to adults, young children are in a period of rapid lung and skeletal growth and the effect of pulmonary irradiation might be a failure of alveolar development resulting from impaired cellular proliferation, thus decreasing the number of alveoli. The aim of this study was to detect the shortand long-term pulmonary function changes in young children who received whole lung irradiation at doses which were therapeutically efficient but close to tolerance and we have tried to characterise the physiopathological mechanisms of the changes observed. Actinomycin D which enhances the effects of irradiation, was administered consecutively.1

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“…Scoliosis caused by unilateral irradiation was the most obvious abnormality and has been extensively discussed [11,17]. Differences of extent can be ascribed to different periods of follow up.…”

Section: Discussionmentioning

confidence: 99%

“…Changes after megavolt irradiation of Wilm's tumour have been reported with a short follow up [11], and observations over a longer period have only been made in very few patients [10].…”

Section: Introductionmentioning

confidence: 99%

Spinal growth after irradiation for Wilm's tumour

Scheibel-Jost

Pfeil

Niethard

et al. 1991

International Orthopaedics

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Between 1960 and 1983, 82 children were treated for Wilm's tumour at our hospital. The secondary effects and changes in the skeleton have been assessed. Radiotherapy was found to cause growth disturbances and osteochondrosis of variable degree, but not osteonecrosis. Since irradiation produces late damage, it should be applied symmetrically to the spine and the dose limited as far as is possible. A long follow up is necessary since skeletal damage can only be assessed after the end of growth.

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Skeletal effects of megavoltage irradiation in survivors of Wilms' tumor

Cited by 72 publications

References 8 publications

The effect of X-rays on bone: a pictorial review

The effect of X-rays on bone: a pictorial review

Effects of pulmonary function of whole lung irradiation for Wilm's tumour in children.

Spinal growth after irradiation for Wilm's tumour

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