Patients and methods
dental abnormalities in survivors of acute lymphoblastic leukemia (ALL). We reviewed the clinical records and panoramicWe reviewed the medical records and panoramic dental radiographs of 423 survivors of ALL who were treated on one of radiographs of all children treated for ALL at our institution children who are nearing dental maturity are less likely to (n ؍ 80), hypodontia in 8.5% (n ؍ 36), taurodontia in 5.9% (n ؍ 25), and over-retention of primary dentition in 4.0% develop dental sequelae, we included only those children (n ؍ 17). Patients who were р8 years old at diagnosis or who who were diagnosed on or before their 13th birthday and received cranial irradiation therapy developed more dental excluded those whose radiographs documented complete perabnormalities than did those Ͼ8 years and those who did not manent dentition or whose therapy did not conform to stan-
Cranial radiation used to treat children with ALL has significant long term sequelae in terms of poorer academic achievement and psychosocial functioning. These data add weight to the conclusion that CRT prophylaxis should only be used to treat children who are at high risk of CNS relapse.
Lacunes may be caused by therapy-induced vasculopathy in children with brain tumors, with the most significant predictor being age less than 5 years at the time of radiotherapy.
A greater tumor burden at diagnosis adversely influences the treatment outcome of children with NHL and CNS disease at diagnosis, suggesting a need for ongoing improvement in both systemic and CNS-directed therapy.
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