Effects of radiation therapy on growing long bones

Smet, AA De; Kuhns, LR; Fayos, J.V.; Holt, JF

doi:10.2214/ajr.127.6.935

Cited by 44 publications

(10 citation statements)

References 2 publications

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“…Animal and clinical evidence suggests that radiation may affect bone formation by: 1) arresting chondrogenesis at the epiphyseal growth plate, 2) inducing absorption failure of calcified cartilage and bone at the metaphysis, and 3) altering diaphyseal periosteal activity (39–41). Flat bones grow primarily by membranous ossification may present with diminished or asymmetrical growth after irradiation (Figure 2) (33).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Selected Musculoskeletal Late Effects in Survivors of Childhood Cancer

Gawade¹,

Hudson²,

Kaste³

et al. 2015

CPR

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Survivors of childhood cancer are at risk for treatment-related musculoskeletal late effects. Early detection and orthopedic intervention can help ameliorate musculoskeletal late effects and prevent subsequent complications. This systematic review summarizes the literature describing associations between cancer, its treatment, and musculoskeletal late effects. We searched PubMed and Web of Science for English language articles published between January 1970 and December 2012. The search was limited to investigations with at least 15 participants and conducted at least 2 years after completion of therapy for childhood, adolescent, or young adult cancer. Some late skeletal effects, including low bone mineral density, osteonecrosis, slipped capital femoral epiphyses, oncogenic rickets, and hormone-related growth disturbances have been previously reviewed and were excluded, as were outcomes following amputation and limb-salvage procedures. Of 2347 references identified, 30 met inclusion criteria and were retained. An additional 54 studies that met inclusion criteria were found in reference lists of retained studies. Of 84 studies, 60 focused on associations between radiotherapy, six between chemotherapy, and 18 between surgery and musculoskeletal late effects. We found that younger age, higher radiation dosage, and asymmetric or partial bone radiation volume influences the effects of radiation on the musculoskeletal system. Methotrexate and vincristine are associated with long-term muscular strength and flexibility deficits. Laminectomy and chest wall resection are associated with spinal malalignment, and enucleation is associated with orbital deformities among survivors. Radiotherapy, chemotherapy, and surgery are associated with musculoskeletal late effects independently and additively. Associations are additionally influenced by host and treatment characteristics.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review of Selected Musculoskeletal Late Effects in Survivors of Childhood Cancer

Gawade¹,

Hudson²,

Kaste³

et al. 2015

CPR

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“…The effects of radiation are believed to affect bone formation by arresting chondrogenesis in the epiphyseal growth plate, interfering with bone and cartilage absorption at the metaphysis, and altering periosteal activity in the diaphysis [17-19]. It is important to note that while treatments such as CSI specifically target the spine, RT to the neck (i.e., head and neck tumors), chest (i.e., Hodgkin’s disease), and abdomen/pelvis (i.e., Wilms’ tumor and neuroblastoma) may also result in significant exposure of the spine to radiation and subsequent impairments in growth [20-22].…”

Section: Growth Impairment and Short Adult Height Following Exposure mentioning

confidence: 99%

Growth Disturbances in Childhood Cancer Survivors

Antal

Balachandar

2019

Horm Res Paediatr

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Survival from childhood cancer has improved dramatically over the last few decades, resulting in an increased need to address the long-term follow-up and care of childhood cancer survivors. Appropriate linear growth is an important measure of health, with alterations of growth in children and short adult height in those who have completed growth serving as potential indicators of the sequelae of the underlying diagnosis or the cancer treatments. It is therefore critical that clinicians, particularly endocrinologists, be familiar with the patterns of altered growth which may be seen following diagnosis and treatment for childhood cancer. In this article, we will review the growth alterations seen in childhood cancer survivors, focusing on risk factors and considerations in evaluation and care.

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“…Acute and long-term effects of radiation on the bone occur by direct damage to osteocytes and altered bone formation through arrest of chondrogenesis at the epiphyseal growth plate, failure to absorb calcified cartilage at the bone metaphysis, and altered diaphyseal periosteal activity. (83-85) Common musculoskeletal manifestations following radiation are many and include short stature due to physeal damage, scoliosis, kyphosis, angular deformities, vertebral fractures, avascular necrosis, Slipped Capital Femoral Epiphysis (SCFE), and the development of secondary benign or malignant tumors. (86-88) Additional radiation-associated late effects of the spine include changes of vertebral trabecular microarchitecture,(89) as well as a disproportionately large reduction in sitting height relative to standing height.…”

Section: Skeletal Late Effects Of Radiotherapymentioning

confidence: 99%

Skeletal Morbidity in Children and Adolescents during and following Cancer Therapy

Mostoufi‐Moab

Ward

2018

Horm Res Paediatr

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Skeletal abnormalities are common in children and adolescents diagnosed and treated for a malignancy. The spectrum ranges from mild pain to debilitating osteonecrosis and fractures. In this review, we summarize the impact of cancer therapy on the developing skeleton, provide an update on therapeutic strategies for prevention and treatment, and discuss the most recent advances in musculoskeletal research. Early recognition of skeletal abnormalities and strategies to optimize bone health are essential to prevent long-term skeletal sequelae and diminished quality of life in childhood cancer survivors.

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Effects of radiation therapy on growing long bones

Cited by 44 publications

References 2 publications

A Systematic Review of Selected Musculoskeletal Late Effects in Survivors of Childhood Cancer

A Systematic Review of Selected Musculoskeletal Late Effects in Survivors of Childhood Cancer

Growth Disturbances in Childhood Cancer Survivors

Skeletal Morbidity in Children and Adolescents during and following Cancer Therapy

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